Flanagan, Madeline, Rattan, Arsheeya, Au, Ling Shan, Patabendige, Malitha, Whigham, Carole-Ann, Jans, Suze, Cofie, Patience, Hofmeyr, G Justus, Rosseland, Leiv Arne, Weeks, Andrew 
ORCID: 0000-0002-1909-337X et al (show 2 more authors)
(2026)
The Effectiveness of Oxytocin for Preventing Postpartum Haemorrhage: An Individual Participant Data Meta-Analysis
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 133 (1).
pp. 24-33.
ISSN 1470-0328, 1471-0528
Abstract
Background: Post-partum haemorrhage (PPH) is a common complication of labour. Objective: To assess the effectiveness of oxytocin in comparison to no treatment for preventing PPH. Selection Criteria: Published and unpublished randomised controlled trials (RCTs) comparing systemic oxytocin to placebo or no intervention for preventing PPH were included. We did not apply language restrictions. Search Strategy: We identified RCTs from the Cochrane network meta-analysis on uterotonics for preventing PPH and updated the search via: Ovid MEDLINE, Embase via Ovid, Web of Science, CENTRAL, CINAHL Plus and clinicaltrials.gov. Data Collection and Analysis: An Individual participant data (IPD) meta-analysis. Main Results: Of 14 eligible RCTs, four provided IPD (n = 4304; 51.7% received oxytocin and 48.4% received placebo or no intervention). Meta-analysis of IPD showed that oxytocin decreased the risk of PPH ≥ 500 mL (aOR 0.59; 95% CI 0.46 to 0.74) and PPH ≥ 1000 mL (aOR 0.51; 95% CI 0.32 to 0.80). Of 10 RCTs that did not share data, seven met trustworthiness criteria while three did not. Trustworthy IPD and aggregate data (AD) from RCTs meeting trustworthiness criteria (n = 6003) showed that oxytocin significantly reduced the rate of PPH ≥ 500 mL (aOR 0.53; 95% CI 0.45 to 0.62) and PPH ≥ 1000 mL (aOR 0.59; 95% CI 0.48 to 0.71). RCTs not meeting trustworthiness criteria reported a larger risk reduction of oxytocin for PPH ≥ 500 mL (n = 1027; aOR 0.37; 95% CI 0.03 to 4.03) and PPH ≥ 1000 mL (n = 1157; aOR 0.13; 95% CI 0.01 to 1.45). Conclusions: Prophylactic oxytocin reduces the risk of PPH ≥ 500 mL and PPH ≥ 1000 mL compared to no treatment. Twenty-one percent of RCTs did not meet our pre-defined trustworthiness criteria, underlining the importance of integrity assessment in evidence synthesis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | meta-analysis, oxytocin, postpartum haemorrhage, randomised controlled trial |
| Divisions: | Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Inst. Life Courses & Medical Sciences (T&R staff) Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Women's & Children's Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 01 Dec 2025 09:08 |
| Last Modified: | 16 Jun 2026 20:11 |
| DOI: | 10.1111/1471-0528.18279 |
| Open Access URL: | https://obgyn.onlinelibrary.wiley.com/doi/10.1111/... |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3195729 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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