Results from a clinical study presented at ANESTHESIOLOGY 2010 suggest that a women’s labor experience is tied to her ethnicity as well as genetics.
The study found differences in the receptor that controls uterine muscle contractions, the beta-2-adrenergic receptor (B2AR genotype C at the 27 position), which predicted later transition to active labor.
This genetic difference is common in Asian women and may account for findings that Asian women transition to active labor later.
Black women had slower early stage labor, which could last over 36 hours. Heavy women also had much slower early labor. Epidurals were generally associated with a 30 percent longer labor time.
“We do not believe that the epidural actually slows the labor, but rather patients who are having a slower, difficult labor ask for an epidural earlier,” said Elena Reitman, M.D., lead author of the study and Post Doctoral Clinical Fellow in Obstetrical Anesthesiology at Columbia University Medical Center.
Regarding pain levels, the study identified the mother’s sensitivity to cold was correlated with increased labor pain. Researchers hypothesized that the cold difference might be due to differences in a receptor on the uterine muscle that detected both cold and pain.
The study’s model predicted that women who require instrumental (such as forceps) vaginal delivery start off with more pain possibly because the baby’s head is not in the most common presentation which is head-down, facing the mother’s back, with its chin tucked to its chest and the back of the head ready to enter the pelvis.
Source: American Society of Anesthesiologists (ASA)