Abstract
This paper develops a mathematical model describing the potential buildup of high oxytocin concentrations in the maternal circulation during labor in terms of continuous Pitocin infusion rate, half-life, and maternal weight. Oxytocin override of the degradation of oxytocin by placental oxytocinase is introduced to model the potential transfer of oxytocin from the maternal circulation across the placenta into the fetal circulation and from there into the brain of the fetus. The desensitization unit D equal to 1.8E6 (pg·min)/ml is employed to establish a desensitization threshold and by extension, a downregulation threshold as a function of oxytocin override concentration and continuous Pitocin infusion time, that could be a factor in the subsequent development of autism among offspring. Epidemiological studies by Duke University [1], Yale University [2], and Harvard University [3] are discussed regarding Pitocin use and offspring autism development for an explanation of the weak correlations they identified. The findings of the Harvard epidemiological study are reinterpreted regarding Pitocin use and its conclusion questioned. Further evaluations of the findings of these three epidemiological studies are called for to incorporate medical information on quantity of Pitocin used, continuous Pitocin infusion rate, length of labor, and maternal weight to determine if a correlation can be established with offspring autism development above an empirically determined desensitization threshold for Pitocin use. Suggestions for research are discussed, including an alternative to continuous Pitocin infusion, pulsatile infusion of Pitocin during labor induction, which may mitigate possible offspring autism development.
Highlights
An epidemiological study by Duke University published in 2013 that was conducted in North Carolina found a modest association between labor induction and labor augmentation with the incidence of autism among the offspring [1]. is study found a weak correlation between the use of Pitocin, artificial oxytocin, during labor and offspring autism development
There are gaps in the scientific information needed to fully support the thesis presented in this paper, it is plausible that Oxytocin receptor (OTR) desensitization in the brain of the fetus is possible during long labors with long Pitocin infusion times with high continuous Pitocin infusion rates, especially for smaller mothers with less-efficient kidneys and livers for removing oxytocin
E quantity of Pitocin used, the average infusion rate, the length of the labor, and the weight of the mother at the time of birth are factors that could affect a correlation between the use of Pitocin during labor and the occurrence of autism among the offspring. is paper asserts that this correlation, if found, may occur above an empirically determined desensitization threshold associated with the desensitization of the OTRs in the brain of the fetus
Summary
An epidemiological study by Duke University published in 2013 that was conducted in North Carolina found a modest association between labor induction and labor augmentation with the incidence of autism among the offspring [1]. is study found a weak correlation between the use of Pitocin, artificial oxytocin, during labor and offspring autism development. Is paper demonstrates that autism attributable to OTR desensitization arising from the use of Pitocin would be shown not to occur for labor inductions that have usual time frames, which can go from six hours [5] to 12 hours or more for continuous Pitocin infusion [6] This mathematical model does indicate that OTR desensitization may occur in some cases of long labor induction and long labor augmentation, in which high Pitocin infusion rates are administered over long labors with long Pitocin infusion times. The earlier paper did not consider the e ects of high continuous infusion rates over the course of long labors with long Pitocin infusion times on OTR desensitization with possible o spring autism development, which this paper does
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