The Effect of the Use of Oxytocin in Labor on Neonatal Jaundice: A Systematic Review and Meta-Analysis

Background: Neonatal Jaundice is a common problem that occurs in most preterm and term neonates. This systematic review aimed to examine the evidence for the effects of oxytocin in labor on neonatal jaundice. Materials and Methods: In this systematic review study, English databases including PubMed, Google Scholar, Embase, Cochrane Library, Scopus, Web of Sciences, and Persian databases including SID, Magiran, and Barakat Knowledge Network System Were searched from Jan 1980 to Dec 2017. Persian and English human clinical trials were targeted. The review was limited to human clinical trials examining the effect of oxytocin in labor on neonatal jaundice. The searched MESH vocabulary was "neonatal hyperbilirubinemia" OR "jaundice" in combination with "oxytocin in labor" OR "induction of labor". Two authors examined the articles separately and the disagreements were resolved through discussion. Results: Out of 583 articles searched in the databases, 440 title, 83 abstracts, and 60 full texts were reviewed, of which 5 English language articles entered the study and 4 articles entered the meta-analysis. Meta-analysis results showed that oxytocin did not affect the serum bilirubin level of the umbilical cord (Mean difference: 1.60; 95% confidence interval [CI]:-2.50 to 5.69; P=0.44; I2=78%). Furthermore, administering oxytocin in labor did not significantly affect serum bilirubin level on days 1 (-0.32; -1.36 to 0.71; P=0.54; I2=72%), and day 3 (3.75; -11.76 to 18.90; P=0.65; I2=63%), while it significantly affected serum bilirubin level on day 2 (-1.63; -2.81 to -0.45; P=0.007; I2=0%). Conclusion: The result of meta-analysis showed that the administration of oxytocin during labor does not affect serum bilirubin level on days 1 and 3, while induction of labor with oxytocin causes serum bilirubin to increase on the second postnatal day. However, due to the high heterogeneity of the studies, better designed clinical trials are recommended to achieve better results