J Vis Exp. 2025 Sep 16;(223). doi: 10.3791/69160.
ABSTRACT
Genetic polymorphisms in CYP3A4, COMT V158M, and OPRM A118G may influence analgesic response, hemodynamic regulation, and postpartum recovery, while parity is thought to affect labor outcomes and adverse events. This study investigated how these genotypes and parity impact maternal and neonatal outcomes, labor duration, pain control, and postpartum complications in 380 pregnant women stratified by genotype. Data on baseline characteristics, labor duration, VAS pain scores, and postpartum adverse events were collected, and safety indicators such as blood pressure, heart rate, fetal outcomes, and Apgar scores were analyzed. Associations between parity and postpartum responses were explored using univariate and logistic regression models. Baseline variables were largely comparable across genotypes except for a higher BMI in the CYP3A4 CT/TT group. Sufentanil consumption was significantly higher in CYP3A4 CT/TT and OPRM A118G GA/GG carriers, although labor duration did not differ among genotypes. OPRM A118G GA/GG carriers also showed a higher incidence of fever (P = 0.016) and greater reductions in blood pressure after intervention (P < 0.001), though all groups achieved similar pain relief. Multiparas experienced less urinary retention (P = 0.005) but more pruritus (P = 0.011), and logistic regression confirmed smaller decreases in systolic blood pressure (OR = 1.049, P = 0.001) and lower risk of pruritus (OR = 0.326, P = 0.01) in this group. Although CYP3A4, COMT, and OPRM A118G genotypes did not broadly influence maternal or neonatal outcomes, carriers of CYP3A4 CT/TT and OPRM A118G GA/GG required higher sufentanil doses and displayed genotype-specific hemodynamic responses, while parity was associated with distinct adverse event profiles and blood pressure changes. These findings highlight the relevance of genetic polymorphisms and parity in guiding personalized postpartum care.
PMID:41052036 | DOI:10.3791/69160
