what is discussion in a research paper

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The purpose of the discussion section is to interpret and describe the significance of your findings in relation to what was already known about the research problem being investigated and to explain any new understanding or insights that emerged as a result of your research. The discussion will always connect to the introduction by way of the research questions or hypotheses you posed and the literature you reviewed, but the discussion does not simply repeat or rearrange the first parts of your paper; the discussion clearly explains how your study advanced the reader's understanding of the research problem from where you left them at the end of your review of prior research.

Annesley, Thomas M. “The Discussion Section: Your Closing Argument.” Clinical Chemistry 56 (November 2010): 1671-1674; Peacock, Matthew. “Communicative Moves in the Discussion Section of Research Articles.” System 30 (December 2002): 479-497.

Importance of a Good Discussion

The discussion section is often considered the most important part of your research paper because it:

• Most effectively demonstrates your ability as a researcher to think critically about an issue, to develop creative solutions to problems based upon a logical synthesis of the findings, and to formulate a deeper, more profound understanding of the research problem under investigation;
• Presents the underlying meaning of your research, notes possible implications in other areas of study, and explores possible improvements that can be made in order to further develop the concerns of your research;
• Highlights the importance of your study and how it can contribute to understanding the research problem within the field of study;
• Presents how the findings from your study revealed and helped fill gaps in the literature that had not been previously exposed or adequately described; and,
• Engages the reader in thinking critically about issues based on an evidence-based interpretation of findings; it is not governed strictly by objective reporting of information.

Annesley Thomas M. “The Discussion Section: Your Closing Argument.” Clinical Chemistry 56 (November 2010): 1671-1674; Bitchener, John and Helen Basturkmen. “Perceptions of the Difficulties of Postgraduate L2 Thesis Students Writing the Discussion Section.” Journal of English for Academic Purposes 5 (January 2006): 4-18; Kretchmer, Paul. Fourteen Steps to Writing an Effective Discussion Section. San Francisco Edit, 2003-2008.

Structure and Writing Style

I.  General Rules

These are the general rules you should adopt when composing your discussion of the results :

• Do not be verbose or repetitive; be concise and make your points clearly
• Avoid the use of jargon or undefined technical language
• Follow a logical stream of thought; in general, interpret and discuss the significance of your findings in the same sequence you described them in your results section [a notable exception is to begin by highlighting an unexpected result or a finding that can grab the reader's attention]
• Use the present verb tense, especially for established facts; however, refer to specific works or prior studies in the past tense
• If needed, use subheadings to help organize your discussion or to categorize your interpretations into themes

II.  The Content

The content of the discussion section of your paper most often includes :

• Explanation of results : Comment on whether or not the results were expected for each set of findings; go into greater depth to explain findings that were unexpected or especially profound. If appropriate, note any unusual or unanticipated patterns or trends that emerged from your results and explain their meaning in relation to the research problem.
• References to previous research : Either compare your results with the findings from other studies or use the studies to support a claim. This can include re-visiting key sources already cited in your literature review section, or, save them to cite later in the discussion section if they are more important to compare with your results instead of being a part of the general literature review of prior research used to provide context and background information. Note that you can make this decision to highlight specific studies after you have begun writing the discussion section.
• Deduction : A claim for how the results can be applied more generally. For example, describing lessons learned, proposing recommendations that can help improve a situation, or highlighting best practices.
• Hypothesis : A more general claim or possible conclusion arising from the results [which may be proved or disproved in subsequent research]. This can be framed as new research questions that emerged as a consequence of your analysis.

III.  Organization and Structure

Keep the following sequential points in mind as you organize and write the discussion section of your paper:

• Think of your discussion as an inverted pyramid. Organize the discussion from the general to the specific, linking your findings to the literature, then to theory, then to practice [if appropriate].
• Use the same key terms, narrative style, and verb tense [present] that you used when describing the research problem in your introduction.
• Begin by briefly re-stating the research problem you were investigating and answer all of the research questions underpinning the problem that you posed in the introduction.
• Describe the patterns, principles, and relationships shown by each major findings and place them in proper perspective. The sequence of this information is important; first state the answer, then the relevant results, then cite the work of others. If appropriate, refer the reader to a figure or table to help enhance the interpretation of the data [either within the text or as an appendix].
• Regardless of where it's mentioned, a good discussion section includes analysis of any unexpected findings. This part of the discussion should begin with a description of the unanticipated finding, followed by a brief interpretation as to why you believe it appeared and, if necessary, its possible significance in relation to the overall study. If more than one unexpected finding emerged during the study, describe each of them in the order they appeared as you gathered or analyzed the data. As noted, the exception to discussing findings in the same order you described them in the results section would be to begin by highlighting the implications of a particularly unexpected or significant finding that emerged from the study, followed by a discussion of the remaining findings.
• Before concluding the discussion, identify potential limitations and weaknesses if you do not plan to do so in the conclusion of the paper. Comment on their relative importance in relation to your overall interpretation of the results and, if necessary, note how they may affect the validity of your findings. Avoid using an apologetic tone; however, be honest and self-critical [e.g., in retrospect, had you included a particular question in a survey instrument, additional data could have been revealed].
• The discussion section should end with a concise summary of the principal implications of the findings regardless of their significance. Give a brief explanation about why you believe the findings and conclusions of your study are important and how they support broader knowledge or understanding of the research problem. This can be followed by any recommendations for further research. However, do not offer recommendations which could have been easily addressed within the study. This would demonstrate to the reader that you have inadequately examined and interpreted the data.

IV.  Overall Objectives

The objectives of your discussion section should include the following: I.  Reiterate the Research Problem/State the Major Findings

Briefly reiterate the research problem or problems you are investigating and the methods you used to investigate them, then move quickly to describe the major findings of the study. You should write a direct, declarative, and succinct proclamation of the study results, usually in one paragraph.

II.  Explain the Meaning of the Findings and Why They are Important

No one has thought as long and hard about your study as you have. Systematically explain the underlying meaning of your findings and state why you believe they are significant. After reading the discussion section, you want the reader to think critically about the results and why they are important. You don’t want to force the reader to go through the paper multiple times to figure out what it all means. If applicable, begin this part of the section by repeating what you consider to be your most significant or unanticipated finding first, then systematically review each finding. Otherwise, follow the general order you reported the findings presented in the results section.

III.  Relate the Findings to Similar Studies

No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your results to those found in other studies, particularly if questions raised from prior studies served as the motivation for your research. This is important because comparing and contrasting the findings of other studies helps to support the overall importance of your results and it highlights how and in what ways your study differs from other research about the topic. Note that any significant or unanticipated finding is often because there was no prior research to indicate the finding could occur. If there is prior research to indicate this, you need to explain why it was significant or unanticipated. IV.  Consider Alternative Explanations of the Findings

It is important to remember that the purpose of research in the social sciences is to discover and not to prove . When writing the discussion section, you should carefully consider all possible explanations for the study results, rather than just those that fit your hypothesis or prior assumptions and biases. This is especially important when describing the discovery of significant or unanticipated findings.

V.  Acknowledge the Study’s Limitations

It is far better for you to identify and acknowledge your study’s limitations than to have them pointed out by your professor! Note any unanswered questions or issues your study could not address and describe the generalizability of your results to other situations. If a limitation is applicable to the method chosen to gather information, then describe in detail the problems you encountered and why. VI.  Make Suggestions for Further Research

You may choose to conclude the discussion section by making suggestions for further research [as opposed to offering suggestions in the conclusion of your paper]. Although your study can offer important insights about the research problem, this is where you can address other questions related to the problem that remain unanswered or highlight hidden issues that were revealed as a result of conducting your research. You should frame your suggestions by linking the need for further research to the limitations of your study [e.g., in future studies, the survey instrument should include more questions that ask..."] or linking to critical issues revealed from the data that were not considered initially in your research.

NOTE: Besides the literature review section, the preponderance of references to sources is usually found in the discussion section . A few historical references may be helpful for perspective, but most of the references should be relatively recent and included to aid in the interpretation of your results, to support the significance of a finding, and/or to place a finding within a particular context. If a study that you cited does not support your findings, don't ignore it--clearly explain why your research findings differ from theirs.

V.  Problems to Avoid

• Do not waste time restating your results . Should you need to remind the reader of a finding to be discussed, use "bridge sentences" that relate the result to the interpretation. An example would be: “In the case of determining available housing to single women with children in rural areas of Texas, the findings suggest that access to good schools is important...," then move on to further explaining this finding and its implications.
• As noted, recommendations for further research can be included in either the discussion or conclusion of your paper, but do not repeat your recommendations in the both sections. Think about the overall narrative flow of your paper to determine where best to locate this information. However, if your findings raise a lot of new questions or issues, consider including suggestions for further research in the discussion section.
• Do not introduce new results in the discussion section. Be wary of mistaking the reiteration of a specific finding for an interpretation because it may confuse the reader. The description of findings [results section] and the interpretation of their significance [discussion section] should be distinct parts of your paper. If you choose to combine the results section and the discussion section into a single narrative, you must be clear in how you report the information discovered and your own interpretation of each finding. This approach is not recommended if you lack experience writing college-level research papers.
• Use of the first person pronoun is generally acceptable. Using first person singular pronouns can help emphasize a point or illustrate a contrasting finding. However, keep in mind that too much use of the first person can actually distract the reader from the main points [i.e., I know you're telling me this--just tell me!].

Analyzing vs. Summarizing. Department of English Writing Guide. George Mason University; Discussion. The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Hess, Dean R. "How to Write an Effective Discussion." Respiratory Care 49 (October 2004); Kretchmer, Paul. Fourteen Steps to Writing to Writing an Effective Discussion Section. San Francisco Edit, 2003-2008; The Lab Report. University College Writing Centre. University of Toronto; Sauaia, A. et al. "The Anatomy of an Article: The Discussion Section: "How Does the Article I Read Today Change What I Will Recommend to my Patients Tomorrow?” The Journal of Trauma and Acute Care Surgery 74 (June 2013): 1599-1602; Research Limitations & Future Research . Lund Research Ltd., 2012; Summary: Using it Wisely. The Writing Center. University of North Carolina; Schafer, Mickey S. Writing the Discussion. Writing in Psychology course syllabus. University of Florida; Yellin, Linda L. A Sociology Writer's Guide . Boston, MA: Allyn and Bacon, 2009.

Writing Tip

Don’t Over-Interpret the Results!

Interpretation is a subjective exercise. As such, you should always approach the selection and interpretation of your findings introspectively and to think critically about the possibility of judgmental biases unintentionally entering into discussions about the significance of your work. With this in mind, be careful that you do not read more into the findings than can be supported by the evidence you have gathered. Remember that the data are the data: nothing more, nothing less.

MacCoun, Robert J. "Biases in the Interpretation and Use of Research Results." Annual Review of Psychology 49 (February 1998): 259-287; Ward, Paulet al, editors. The Oxford Handbook of Expertise . Oxford, UK: Oxford University Press, 2018.

Another Writing Tip

Don't Write Two Results Sections!

One of the most common mistakes that you can make when discussing the results of your study is to present a superficial interpretation of the findings that more or less re-states the results section of your paper. Obviously, you must refer to your results when discussing them, but focus on the interpretation of those results and their significance in relation to the research problem, not the data itself.

Azar, Beth. "Discussing Your Findings."  American Psychological Association gradPSYCH Magazine (January 2006).

Yet Another Writing Tip

Avoid Unwarranted Speculation!

The discussion section should remain focused on the findings of your study. For example, if the purpose of your research was to measure the impact of foreign aid on increasing access to education among disadvantaged children in Bangladesh, it would not be appropriate to speculate about how your findings might apply to populations in other countries without drawing from existing studies to support your claim or if analysis of other countries was not a part of your original research design. If you feel compelled to speculate, do so in the form of describing possible implications or explaining possible impacts. Be certain that you clearly identify your comments as speculation or as a suggestion for where further research is needed. Sometimes your professor will encourage you to expand your discussion of the results in this way, while others don’t care what your opinion is beyond your effort to interpret the data in relation to the research problem.

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• How to Write Discussions and Conclusions

The discussion section contains the results and outcomes of a study. An effective discussion informs readers what can be learned from your experiment and provides context for the results.

What makes an effective discussion?

When you’re ready to write your discussion, you’ve already introduced the purpose of your study and provided an in-depth description of the methodology. The discussion informs readers about the larger implications of your study based on the results. Highlighting these implications while not overstating the findings can be challenging, especially when you’re submitting to a journal that selects articles based on novelty or potential impact. Regardless of what journal you are submitting to, the discussion section always serves the same purpose: concluding what your study results actually mean.

A successful discussion section puts your findings in context. It should include:

• the results of your research,
• a discussion of related research, and
• a comparison between your results and initial hypothesis.

Tip: Not all journals share the same naming conventions.

You can apply the advice in this article to the conclusion, results or discussion sections of your manuscript.

Our Early Career Researcher community tells us that the conclusion is often considered the most difficult aspect of a manuscript to write. To help, this guide provides questions to ask yourself, a basic structure to model your discussion off of and examples from published manuscripts. 

Questions to ask yourself:

• Was my hypothesis correct?
• If my hypothesis is partially correct or entirely different, what can be learned from the results? 
• How do the conclusions reshape or add onto the existing knowledge in the field? What does previous research say about the topic? 
• Why are the results important or relevant to your audience? Do they add further evidence to a scientific consensus or disprove prior studies? 
• How can future research build on these observations? What are the key experiments that must be done? 
• What is the “take-home” message you want your reader to leave with?

How to structure a discussion

Trying to fit a complete discussion into a single paragraph can add unnecessary stress to the writing process. If possible, you’ll want to give yourself two or three paragraphs to give the reader a comprehensive understanding of your study as a whole. Here’s one way to structure an effective discussion:

Writing Tips

While the above sections can help you brainstorm and structure your discussion, there are many common mistakes that writers revert to when having difficulties with their paper. Writing a discussion can be a delicate balance between summarizing your results, providing proper context for your research and avoiding introducing new information. Remember that your paper should be both confident and honest about the results! 

• Read the journal’s guidelines on the discussion and conclusion sections. If possible, learn about the guidelines before writing the discussion to ensure you’re writing to meet their expectations. 
• Begin with a clear statement of the principal findings. This will reinforce the main take-away for the reader and set up the rest of the discussion. 
• Explain why the outcomes of your study are important to the reader. Discuss the implications of your findings realistically based on previous literature, highlighting both the strengths and limitations of the research. 
• State whether the results prove or disprove your hypothesis. If your hypothesis was disproved, what might be the reasons? 
• Introduce new or expanded ways to think about the research question. Indicate what next steps can be taken to further pursue any unresolved questions. 
• If dealing with a contemporary or ongoing problem, such as climate change, discuss possible consequences if the problem is avoided. 
• Be concise. Adding unnecessary detail can distract from the main findings. 

Don’t

• Rewrite your abstract. Statements with “we investigated” or “we studied” generally do not belong in the discussion. 
• Include new arguments or evidence not previously discussed. Necessary information and evidence should be introduced in the main body of the paper. 
• Apologize. Even if your research contains significant limitations, don’t undermine your authority by including statements that doubt your methodology or execution. 
• Shy away from speaking on limitations or negative results. Including limitations and negative results will give readers a complete understanding of the presented research. Potential limitations include sources of potential bias, threats to internal or external validity, barriers to implementing an intervention and other issues inherent to the study design. 
• Overstate the importance of your findings. Making grand statements about how a study will fully resolve large questions can lead readers to doubt the success of the research. 

Snippets of Effective Discussions:

Consumer-based actions to reduce plastic pollution in rivers: A multi-criteria decision analysis approach

Identifying reliable indicators of fitness in polar bears

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How to Write the Discussion Section of a Research Paper

The discussion section of a research paper analyzes and interprets the findings, provides context, compares them with previous studies, identifies limitations, and suggests future research directions.

Updated on September 15, 2023

Structure your discussion section right, and you’ll be cited more often while doing a greater service to the scientific community. So, what actually goes into the discussion section? And how do you write it?

The discussion section of your research paper is where you let the reader know how your study is positioned in the literature, what to take away from your paper, and how your work helps them. It can also include your conclusions and suggestions for future studies.

First, we’ll define all the parts of your discussion paper, and then look into how to write a strong, effective discussion section for your paper or manuscript.

Discussion section: what is it, what it does

The discussion section comes later in your paper, following the introduction, methods, and results. The discussion sets up your study’s conclusions. Its main goals are to present, interpret, and provide a context for your results.

What is it?

The discussion section provides an analysis and interpretation of the findings, compares them with previous studies, identifies limitations, and suggests future directions for research.

This section combines information from the preceding parts of your paper into a coherent story. By this point, the reader already knows why you did your study (introduction), how you did it (methods), and what happened (results). In the discussion, you’ll help the reader connect the ideas from these sections.

Why is it necessary?

The discussion provides context and interpretations for the results. It also answers the questions posed in the introduction. While the results section describes your findings, the discussion explains what they say. This is also where you can describe the impact or implications of your research.

Adds context for your results

Most research studies aim to answer a question, replicate a finding, or address limitations in the literature. These goals are first described in the introduction. However, in the discussion section, the author can refer back to them to explain how the study's objective was achieved. 

Shows what your results actually mean and real-world implications

The discussion can also describe the effect of your findings on research or practice. How are your results significant for readers, other researchers, or policymakers?

What to include in your discussion (in the correct order)

A complete and effective discussion section should at least touch on the points described below.

Summary of key findings

The discussion should begin with a brief factual summary of the results. Concisely overview the main results you obtained.

Begin with key findings with supporting evidence

Your results section described a list of findings, but what message do they send when you look at them all together?

Your findings were detailed in the results section, so there’s no need to repeat them here, but do provide at least a few highlights. This will help refresh the reader’s memory and help them focus on the big picture.

Read the first paragraph of the discussion section in this article (PDF) for an example of how to start this part of your paper. Notice how the authors break down their results and follow each description sentence with an explanation of why each finding is relevant. 

State clearly and concisely

Following a clear and direct writing style is especially important in the discussion section. After all, this is where you will make some of the most impactful points in your paper. While the results section often contains technical vocabulary, such as statistical terms, the discussion section lets you describe your findings more clearly. 

Interpretation of results

Once you’ve given your reader an overview of your results, you need to interpret those results. In other words, what do your results mean? Discuss the findings’ implications and significance in relation to your research question or hypothesis.

Analyze and interpret your findings

Look into your findings and explore what’s behind them or what may have caused them. If your introduction cited theories or studies that could explain your findings, use these sources as a basis to discuss your results.

For example, look at the second paragraph in the discussion section of this article on waggling honey bees. Here, the authors explore their results based on information from the literature.

Unexpected or contradictory results

Sometimes, your findings are not what you expect. Here’s where you describe this and try to find a reason for it. Could it be because of the method you used? Does it have something to do with the variables analyzed? Comparing your methods with those of other similar studies can help with this task.

Context and comparison with previous work

Refer to related studies to place your research in a larger context and the literature. Compare and contrast your findings with existing literature, highlighting similarities, differences, and/or contradictions.

How your work compares or contrasts with previous work

Studies with similar findings to yours can be cited to show the strength of your findings. Information from these studies can also be used to help explain your results. Differences between your findings and others in the literature can also be discussed here. 

How to divide this section into subsections

If you have more than one objective in your study or many key findings, you can dedicate a separate section to each of these. Here’s an example of this approach. You can see that the discussion section is divided into topics and even has a separate heading for each of them. 

Limitations

Many journals require you to include the limitations of your study in the discussion. Even if they don’t, there are good reasons to mention these in your paper.

Why limitations don’t have a negative connotation

A study’s limitations are points to be improved upon in future research. While some of these may be flaws in your method, many may be due to factors you couldn’t predict.

Examples include time constraints or small sample sizes. Pointing this out will help future researchers avoid or address these issues. This part of the discussion can also include any attempts you have made to reduce the impact of these limitations, as in this study .

How limitations add to a researcher's credibility

Pointing out the limitations of your study demonstrates transparency. It also shows that you know your methods well and can conduct a critical assessment of them.  

Implications and significance

The final paragraph of the discussion section should contain the take-home messages for your study. It can also cite the “strong points” of your study, to contrast with the limitations section.

Restate your hypothesis

Remind the reader what your hypothesis was before you conducted the study. 

How was it proven or disproven?

Identify your main findings and describe how they relate to your hypothesis.

How your results contribute to the literature

Were you able to answer your research question? Or address a gap in the literature?

Future implications of your research

Describe the impact that your results may have on the topic of study. Your results may show, for instance, that there are still limitations in the literature for future studies to address. There may be a need for studies that extend your findings in a specific way. You also may need additional research to corroborate your findings. 

Sample discussion section

This fictitious example covers all the aspects discussed above. Your actual discussion section will probably be much longer, but you can read this to get an idea of everything your discussion should cover.

Our results showed that the presence of cats in a household is associated with higher levels of perceived happiness by its human occupants. These findings support our hypothesis and demonstrate the association between pet ownership and well-being. 

The present findings align with those of Bao and Schreer (2016) and Hardie et al. (2023), who observed greater life satisfaction in pet owners relative to non-owners. Although the present study did not directly evaluate life satisfaction, this factor may explain the association between happiness and cat ownership observed in our sample.

Our findings must be interpreted in light of some limitations, such as the focus on cat ownership only rather than pets as a whole. This may limit the generalizability of our results.

Nevertheless, this study had several strengths. These include its strict exclusion criteria and use of a standardized assessment instrument to investigate the relationships between pets and owners. These attributes bolster the accuracy of our results and reduce the influence of confounding factors, increasing the strength of our conclusions. Future studies may examine the factors that mediate the association between pet ownership and happiness to better comprehend this phenomenon.

This brief discussion begins with a quick summary of the results and hypothesis. The next paragraph cites previous research and compares its findings to those of this study. Information from previous studies is also used to help interpret the findings. After discussing the results of the study, some limitations are pointed out. The paper also explains why these limitations may influence the interpretation of results. Then, final conclusions are drawn based on the study, and directions for future research are suggested.

How to make your discussion flow naturally

If you find writing in scientific English challenging, the discussion and conclusions are often the hardest parts of the paper to write. That’s because you’re not just listing up studies, methods, and outcomes. You’re actually expressing your thoughts and interpretations in words.

• How formal should it be?
• What words should you use, or not use?
• How do you meet strict word limits, or make it longer and more informative?

Always give it your best, but sometimes a helping hand can, well, help. Getting a professional edit can help clarify your work’s importance while improving the English used to explain it. When readers know the value of your work, they’ll cite it. We’ll assign your study to an expert editor knowledgeable in your area of research. Their work will clarify your discussion, helping it to tell your story. Find out more about AJE Editing.

Adam Goulston, PsyD, MS, MBA, MISD, ELS

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How to Write a Discussion Section for a Research Paper

We’ve talked about several useful writing tips that authors should consider while drafting or editing their research papers. In particular, we’ve focused on  figures and legends , as well as the Introduction ,  Methods , and  Results . Now that we’ve addressed the more technical portions of your journal manuscript, let’s turn to the analytical segments of your research article. In this article, we’ll provide tips on how to write a strong Discussion section that best portrays the significance of your research contributions.

What is the Discussion section of a research paper?

In a nutshell,  your Discussion fulfills the promise you made to readers in your Introduction . At the beginning of your paper, you tell us why we should care about your research. You then guide us through a series of intricate images and graphs that capture all the relevant data you collected during your research. We may be dazzled and impressed at first, but none of that matters if you deliver an anti-climactic conclusion in the Discussion section!

Are you feeling pressured? Don’t worry. To be honest, you will edit the Discussion section of your manuscript numerous times. After all, in as little as one to two paragraphs ( Nature ‘s suggestion  based on their 3,000-word main body text limit), you have to explain how your research moves us from point A (issues you raise in the Introduction) to point B (our new understanding of these matters). You must also recommend how we might get to point C (i.e., identify what you think is the next direction for research in this field). That’s a lot to say in two paragraphs!

So, how do you do that? Let’s take a closer look.

What should I include in the Discussion section?

As we stated above, the goal of your Discussion section is to  answer the questions you raise in your Introduction by using the results you collected during your research . The content you include in the Discussions segment should include the following information:

• Remind us why we should be interested in this research project.
• Describe the nature of the knowledge gap you were trying to fill using the results of your study.
• Don’t repeat your Introduction. Instead, focus on why  this  particular study was needed to fill the gap you noticed and why that gap needed filling in the first place.
• Mainly, you want to remind us of how your research will increase our knowledge base and inspire others to conduct further research.
• Clearly tell us what that piece of missing knowledge was.
• Answer each of the questions you asked in your Introduction and explain how your results support those conclusions.
• Make sure to factor in all results relevant to the questions (even if those results were not statistically significant).
• Focus on the significance of the most noteworthy results.
• If conflicting inferences can be drawn from your results, evaluate the merits of all of them.
• Don’t rehash what you said earlier in the Results section. Rather, discuss your findings in the context of answering your hypothesis. Instead of making statements like “[The first result] was this…,” say, “[The first result] suggests [conclusion].”
• Do your conclusions line up with existing literature?
• Discuss whether your findings agree with current knowledge and expectations.
• Keep in mind good persuasive argument skills, such as explaining the strengths of your arguments and highlighting the weaknesses of contrary opinions.
• If you discovered something unexpected, offer reasons. If your conclusions aren’t aligned with current literature, explain.
• Address any limitations of your study and how relevant they are to interpreting your results and validating your findings.
• Make sure to acknowledge any weaknesses in your conclusions and suggest room for further research concerning that aspect of your analysis.
• Make sure your suggestions aren’t ones that should have been conducted during your research! Doing so might raise questions about your initial research design and protocols.
• Similarly, maintain a critical but unapologetic tone. You want to instill confidence in your readers that you have thoroughly examined your results and have objectively assessed them in a way that would benefit the scientific community’s desire to expand our knowledge base.
• Recommend next steps.
• Your suggestions should inspire other researchers to conduct follow-up studies to build upon the knowledge you have shared with them.
• Keep the list short (no more than two).

How to Write the Discussion Section

The above list of what to include in the Discussion section gives an overall idea of what you need to focus on throughout the section. Below are some tips and general suggestions about the technical aspects of writing and organization that you might find useful as you draft or revise the contents we’ve outlined above.

Technical writing elements

• Embrace active voice because it eliminates the awkward phrasing and wordiness that accompanies passive voice.
• Use the present tense, which should also be employed in the Introduction.
• Sprinkle with first person pronouns if needed, but generally, avoid it. We want to focus on your findings.
• Maintain an objective and analytical tone.

Discussion section organization

• Keep the same flow across the Results, Methods, and Discussion sections.
• We develop a rhythm as we read and parallel structures facilitate our comprehension. When you organize information the same way in each of these related parts of your journal manuscript, we can quickly see how a certain result was interpreted and quickly verify the particular methods used to produce that result.
• Notice how using parallel structure will eliminate extra narration in the Discussion part since we can anticipate the flow of your ideas based on what we read in the Results segment. Reducing wordiness is important when you only have a few paragraphs to devote to the Discussion section!
• Within each subpart of a Discussion, the information should flow as follows: (A) conclusion first, (B) relevant results and how they relate to that conclusion and (C) relevant literature.
• End with a concise summary explaining the big-picture impact of your study on our understanding of the subject matter. At the beginning of your Discussion section, you stated why  this  particular study was needed to fill the gap you noticed and why that gap needed filling in the first place. Now, it is time to end with “how your research filled that gap.”

Discussion Part 1: Summarizing Key Findings

Begin the Discussion section by restating your  statement of the problem  and briefly summarizing the major results. Do not simply repeat your findings. Rather, try to create a concise statement of the main results that directly answer the central research question that you stated in the Introduction section . This content should not be longer than one paragraph in length.

Many researchers struggle with understanding the precise differences between a Discussion section and a Results section . The most important thing to remember here is that your Discussion section should subjectively evaluate the findings presented in the Results section, and in relatively the same order. Keep these sections distinct by making sure that you do not repeat the findings without providing an interpretation.

Phrase examples: Summarizing the results

• The findings indicate that …
• These results suggest a correlation between A and B …
• The data present here suggest that …
• An interpretation of the findings reveals a connection between…

Discussion Part 2: Interpreting the Findings

What do the results mean? It may seem obvious to you, but simply looking at the figures in the Results section will not necessarily convey to readers the importance of the findings in answering your research questions.

The exact structure of interpretations depends on the type of research being conducted. Here are some common approaches to interpreting data:

• Identifying correlations and relationships in the findings
• Explaining whether the results confirm or undermine your research hypothesis
• Giving the findings context within the history of similar research studies
• Discussing unexpected results and analyzing their significance to your study or general research
• Offering alternative explanations and arguing for your position

Organize the Discussion section around key arguments, themes, hypotheses, or research questions or problems. Again, make sure to follow the same order as you did in the Results section.

Discussion Part 3: Discussing the Implications

In addition to providing your own interpretations, show how your results fit into the wider scholarly literature you surveyed in the  literature review section. This section is called the implications of the study . Show where and how these results fit into existing knowledge, what additional insights they contribute, and any possible consequences that might arise from this knowledge, both in the specific research topic and in the wider scientific domain.

Questions to ask yourself when dealing with potential implications:

• Do your findings fall in line with existing theories, or do they challenge these theories or findings? What new information do they contribute to the literature, if any? How exactly do these findings impact or conflict with existing theories or models?
• What are the practical implications on actual subjects or demographics?
• What are the methodological implications for similar studies conducted either in the past or future?

Your purpose in giving the implications is to spell out exactly what your study has contributed and why researchers and other readers should be interested.

Phrase examples: Discussing the implications of the research

• These results confirm the existing evidence in X studies…
• The results are not in line with the foregoing theory that…
• This experiment provides new insights into the connection between…
• These findings present a more nuanced understanding of…
• While previous studies have focused on X, these results demonstrate that Y.

Step 4: Acknowledging the limitations

All research has study limitations of one sort or another. Acknowledging limitations in methodology or approach helps strengthen your credibility as a researcher. Study limitations are not simply a list of mistakes made in the study. Rather, limitations help provide a more detailed picture of what can or cannot be concluded from your findings. In essence, they help temper and qualify the study implications you listed previously.

Study limitations can relate to research design, specific methodological or material choices, or unexpected issues that emerged while you conducted the research. Mention only those limitations directly relate to your research questions, and explain what impact these limitations had on how your study was conducted and the validity of any interpretations.

Possible types of study limitations:

• Insufficient sample size for statistical measurements
• Lack of previous research studies on the topic
• Methods/instruments/techniques used to collect the data
• Limited access to data
• Time constraints in properly preparing and executing the study

After discussing the study limitations, you can also stress that your results are still valid. Give some specific reasons why the limitations do not necessarily handicap your study or narrow its scope.

Phrase examples: Limitations sentence beginners

• “There may be some possible limitations in this study.”
• “The findings of this study have to be seen in light of some limitations.”
•  “The first limitation is the…The second limitation concerns the…”
•  “The empirical results reported herein should be considered in the light of some limitations.”
• “This research, however, is subject to several limitations.”
• “The primary limitation to the generalization of these results is…”
• “Nonetheless, these results must be interpreted with caution and a number of limitations should be borne in mind.”

Discussion Part 5: Giving Recommendations for Further Research

Based on your interpretation and discussion of the findings, your recommendations can include practical changes to the study or specific further research to be conducted to clarify the research questions. Recommendations are often listed in a separate Conclusion section , but often this is just the final paragraph of the Discussion section.

Suggestions for further research often stem directly from the limitations outlined. Rather than simply stating that “further research should be conducted,” provide concrete specifics for how future can help answer questions that your research could not.

Phrase examples: Recommendation sentence beginners

• Further research is needed to establish …
• There is abundant space for further progress in analyzing…
• A further study with more focus on X should be done to investigate…
• Further studies of X that account for these variables must be undertaken.

Consider Receiving Professional Language Editing

As you edit or draft your research manuscript, we hope that you implement these guidelines to produce a more effective Discussion section. And after completing your draft, don’t forget to submit your work to a professional proofreading and English editing service like Wordvice, including our manuscript editing service for  paper editing , cover letter editing , SOP editing , and personal statement proofreading services. Language editors not only proofread and correct errors in grammar, punctuation, mechanics, and formatting but also improve terms and revise phrases so they read more naturally. Wordvice is an industry leader in providing high-quality revision for all types of academic documents.

For additional information about how to write a strong research paper, make sure to check out our full  research writing series !

Wordvice Writing Resources

• How to Write a Research Paper Introduction 
• Which Verb Tenses to Use in a Research Paper
• How to Write an Abstract for a Research Paper
• How to Write a Research Paper Title
• Useful Phrases for Academic Writing
• Common Transition Terms in Academic Papers
• Active and Passive Voice in Research Papers
• 100+ Verbs That Will Make Your Research Writing Amazing
• Tips for Paraphrasing in Research Papers

Additional Academic Resources

•   Guide for Authors.  (Elsevier)
•  How to Write the Results Section of a Research Paper.  (Bates College)
•   Structure of a Research Paper.  (University of Minnesota Biomedical Library)
•   How to Choose a Target Journal  (Springer)
•   How to Write Figures and Tables  (UNC Writing Center)

Organizing Academic Research Papers: 8. The Discussion

• Purpose of Guide
• Design Flaws to Avoid
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• How to Manage Group Projects
• Multiple Book Review Essay
• Reviewing Collected Essays
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Acknowledgements

The purpose of the discussion is to interpret and describe the significance of your findings in light of what was already known about the research problem being investigated, and to explain any new understanding or fresh insights about the problem after you've taken the findings into consideration. The discussion will always connect to the introduction by way of the research questions or hypotheses you posed and the literature you reviewed, but it does not simply repeat or rearrange the introduction; the discussion should always explain how your study has moved the reader's understanding of the research problem forward from where you left them at the end of the introduction.

Importance of a Good Discussion

This section is often considered the most important part of a research paper because it most effectively demonstrates your ability as a researcher to think critically about an issue, to develop creative solutions to problems based on the findings, and to formulate a deeper, more profound understanding of the research problem you are studying.

The discussion section is where you explore the underlying meaning of your research , its possible implications in other areas of study, and the possible improvements that can be made in order to further develop the concerns of your research.

This is the section where you need to present the importance of your study and how it may be able to contribute to and/or fill existing gaps in the field. If appropriate, the discussion section is also where you state how the findings from your study revealed new gaps in the literature that had not been previously exposed or adequately described.

This part of the paper is not strictly governed by objective reporting of information but, rather, it is where you can engage in creative thinking about issues through evidence-based interpretation of findings. This is where you infuse your results with meaning.

Kretchmer, Paul. Fourteen Steps to Writing to Writing an Effective Discussion Section . San Francisco Edit, 2003-2008.

Structure and Writing Style

I.  General Rules

These are the general rules you should adopt when composing your discussion of the results :

• Do not be verbose or repetitive.
• Be concise and make your points clearly.
• Avoid using jargon.
• Follow a logical stream of thought.
• Use the present verb tense, especially for established facts; however, refer to specific works and references in the past tense.
• If needed, use subheadings to help organize your presentation or to group your interpretations into themes.

II.  The Content

The content of the discussion section of your paper most often includes :

• Explanation of results : comment on whether or not the results were expected and present explanations for the results; go into greater depth when explaining findings that were unexpected or especially profound. If appropriate, note any unusual or unanticipated patterns or trends that emerged from your results and explain their meaning.
• References to previous research : compare your results with the findings from other studies, or use the studies to support a claim. This can include re-visiting key sources already cited in your literature review section, or, save them to cite later in the discussion section if they are more important to compare with your results than being part of the general research you cited to provide context and background information.
• Deduction : a claim for how the results can be applied more generally. For example, describing lessons learned, proposing recommendations that can help improve a situation, or recommending best practices.
• Hypothesis : a more general claim or possible conclusion arising from the results [which may be proved or disproved in subsequent research].

III. Organization and Structure

Keep the following sequential points in mind as you organize and write the discussion section of your paper:

• Think of your discussion as an inverted pyramid. Organize the discussion from the general to the specific, linking your findings to the literature, then to theory, then to practice [if appropriate].
• Use the same key terms, mode of narration, and verb tense [present] that you used when when describing the research problem in the introduction.
• Begin by briefly re-stating the research problem you were investigating and answer all of the research questions underpinning the problem that you posed in the introduction.
• Describe the patterns, principles, and relationships shown by each major findings and place them in proper perspective. The sequencing of providing this information is important; first state the answer, then the relevant results, then cite the work of others. If appropriate, refer the reader to a figure or table to help enhance the interpretation of the data. The order of interpreting each major finding should be in the same order as they were described in your results section.
• A good discussion section includes analysis of any unexpected findings. This paragraph should begin with a description of the unexpected finding, followed by a brief interpretation as to why you believe it appeared and, if necessary, its possible significance in relation to the overall study. If more than one unexpected finding emerged during the study, describe each them in the order they appeared as you gathered the data.
• Before concluding the discussion, identify potential limitations and weaknesses. Comment on their relative importance in relation to your overall interpretation of the results and, if necessary, note how they may affect the validity of the findings. Avoid using an apologetic tone; however, be honest and self-critical.
• The discussion section should end with a concise summary of the principal implications of the findings regardless of statistical significance. Give a brief explanation about why you believe the findings and conclusions of your study are important and how they support broader knowledge or understanding of the research problem. This can be followed by any recommendations for further research. However, do not offer recommendations which could have been easily addressed within the study. This demonstrates to the reader you have inadequately examined and interpreted the data.

IV.  Overall Objectives

The objectives of your discussion section should include the following: I.  Reiterate the Research Problem/State the Major Findings

Briefly reiterate for your readers the research problem or problems you are investigating and the methods you used to investigate them, then move quickly to describe the major findings of the study. You should write a direct, declarative, and succinct proclamation of the study results.

II.  Explain the Meaning of the Findings and Why They are Important

No one has thought as long and hard about your study as you have. Systematically explain the meaning of the findings and why you believe they are important. After reading the discussion section, you want the reader to think about the results [“why hadn’t I thought of that?”]. You don’t want to force the reader to go through the paper multiple times to figure out what it all means. Begin this part of the section by repeating what you consider to be your most important finding first.

III.  Relate the Findings to Similar Studies

No study is so novel or possesses such a restricted focus that it has absolutely no relation to other previously published research. The discussion section should relate your study findings to those of other studies, particularly if questions raised by previous studies served as the motivation for your study, the findings of other studies support your findings [which strengthens the importance of your study results], and/or they point out how your study differs from other similar studies. IV.  Consider Alternative Explanations of the Findings

It is important to remember that the purpose of research is to discover and not to prove . When writing the discussion section, you should carefully consider all possible explanations for the study results, rather than just those that fit your prior assumptions or biases.

V.  Acknowledge the Study’s Limitations

It is far better for you to identify and acknowledge your study’s limitations than to have them pointed out by your professor! Describe the generalizability of your results to other situations, if applicable to the method chosen, then describe in detail problems you encountered in the method(s) you used to gather information. Note any unanswered questions or issues your study did not address, and.... VI.  Make Suggestions for Further Research

Although your study may offer important insights about the research problem, other questions related to the problem likely remain unanswered. Moreover, some unanswered questions may have become more focused because of your study. You should make suggestions for further research in the discussion section.

NOTE: Besides the literature review section, the preponderance of references to sources in your research paper are usually found in the discussion section . A few historical references may be helpful for perspective but most of the references should be relatively recent and included to aid in the interpretation of your results and/or linked to similar studies. If a study that you cited disagrees with your findings, don't ignore it--clearly explain why the study's findings differ from yours.

V.  Problems to Avoid

• Do not waste entire sentences restating your results . Should you need to remind the reader of the finding to be discussed, use "bridge sentences" that relate the result to the interpretation. An example would be: “The lack of available housing to single women with children in rural areas of Texas suggests that...[then move to the interpretation of this finding].”
• Recommendations for further research can be included in either the discussion or conclusion of your paper but do not repeat your recommendations in the both sections.
• Do not introduce new results in the discussion. Be wary of mistaking the reiteration of a specific finding for an interpretation.
• Use of the first person is acceptable, but too much use of the first person may actually distract the reader from the main points.

Analyzing vs. Summarizing. Department of English Writing Guide. George Mason University; Discussion . The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Hess, Dean R. How to Write an Effective Discussion. Respiratory Care 49 (October 2004); Kretchmer, Paul. Fourteen Steps to Writing to Writing an Effective Discussion Section . San Francisco Edit, 2003-2008; The Lab Report . University College Writing Centre. University of Toronto; Summary: Using it Wisely . The Writing Center. University of North Carolina; Schafer, Mickey S. Writing the Discussion . Writing in Psychology course syllabus. University of Florida; Yellin, Linda L. A Sociology Writer's Guide. Boston, MA: Allyn and Bacon, 2009.

Writing Tip

Don’t Overinterpret the Results!

Interpretation is a subjective exercise. Therefore, be careful that you do not read more into the findings than can be supported by the evidence you've gathered. Remember that the data are the data: nothing more, nothing less.

Another Writing Tip

Don't Write Two Results Sections!

One of the most common mistakes that you can make when discussing the results of your study is to present a superficial interpretation of the findings that more or less re-states the results section of your paper. Obviously, you must refer to your results when discussing them, but focus on the interpretion of those results, not just the data itself.

Azar, Beth. Discussing Your Findings.  American Psychological Association gradPSYCH Magazine (January 2006)

Yet Another Writing Tip

Avoid Unwarranted Speculation!

The discussion section should remain focused on the findings of your study. For example, if you studied the impact of foreign aid on increasing levels of education among the poor in Bangladesh, it's generally not appropriate to speculate about how your findings might apply to populations in other countries without drawing from existing studies to support your claim. If you feel compelled to speculate, be certain that you clearly identify your comments as speculation or as a suggestion for where further research is needed. Sometimes your professor will encourage you to expand the discussion in this way, while others don’t care what your opinion is beyond your efforts to interpret the data.

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Writing a scientific paper.

• Writing a lab report
• INTRODUCTION

Writing a "good" discussion section

"discussion and conclusions checklist" from: how to write a good scientific paper. chris a. mack. spie. 2018., peer review.

• LITERATURE CITED
• Bibliography of guides to scientific writing and presenting
• Presentations
• Lab Report Writing Guides on the Web

This is is usually the hardest section to write. You are trying to bring out the true meaning of your data without being too long. Do not use words to conceal your facts or reasoning. Also do not repeat your results, this is a discussion.

• Present principles, relationships and generalizations shown by the results
• Point out exceptions or lack of correlations. Define why you think this is so.
• Show how your results agree or disagree with previously published works
• Discuss the theoretical implications of your work as well as practical applications
• State your conclusions clearly. Summarize your evidence for each conclusion.
• Discuss the significance of the results
•  Evidence does not explain itself; the results must be presented and then explained.
• Typical stages in the discussion: summarizing the results, discussing whether results are expected or unexpected, comparing these results to previous work, interpreting and explaining the results (often by comparison to a theory or model), and hypothesizing about their generality.
• Discuss any problems or shortcomings encountered during the course of the work.
• Discuss possible alternate explanations for the results.
• Avoid: presenting results that are never discussed; presenting discussion that does not relate to any of the results; presenting results and discussion in chronological order rather than logical order; ignoring results that do not support the conclusions; drawing conclusions from results without logical arguments to back them up. 

CONCLUSIONS

• Provide a very brief summary of the Results and Discussion.
• Emphasize the implications of the findings, explaining how the work is significant and providing the key message(s) the author wishes to convey.
• Provide the most general claims that can be supported by the evidence.
• Provide a future perspective on the work.
• Avoid: repeating the abstract; repeating background information from the Introduction; introducing new evidence or new arguments not found in the Results and Discussion; repeating the arguments made in the Results and Discussion; failing to address all of the research questions set out in the Introduction. 

WHAT HAPPENS AFTER I COMPLETE MY PAPER?

 The peer review process is the quality control step in the publication of ideas.  Papers that are submitted to a journal for publication are sent out to several scientists (peers) who look carefully at the paper to see if it is "good science".  These reviewers then recommend to the editor of a journal whether or not a paper should be published. Most journals have publication guidelines. Ask for them and follow them exactly.    Peer reviewers examine the soundness of the materials and methods section.  Are the materials and methods used written clearly enough for another scientist to reproduce the experiment?  Other areas they look at are: originality of research, significance of research question studied, soundness of the discussion and interpretation, correct spelling and use of technical terms, and length of the article.

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General Research Paper Guidelines: Discussion

Discussion section.

The overall purpose of a research paper’s discussion section is to evaluate and interpret results, while explaining both the implications and limitations of your findings. Per APA (2020) guidelines, this section requires you to “examine, interpret, and qualify the results and draw inferences and conclusions from them” (p. 89). Discussion sections also require you to detail any new insights, think through areas for future research, highlight the work that still needs to be done to further your topic, and provide a clear conclusion to your research paper. In a good discussion section, you should do the following:

• Clearly connect the discussion of your results to your introduction, including your central argument, thesis, or problem statement.
• Provide readers with a critical thinking through of your results, answering the “so what?” question about each of your findings. In other words, why is this finding important?
• Detail how your research findings might address critical gaps or problems in your field
• Compare your results to similar studies’ findings
• Provide the possibility of alternative interpretations, as your goal as a researcher is to “discover” and “examine” and not to “prove” or “disprove.” Instead of trying to fit your results into your hypothesis, critically engage with alternative interpretations to your results.

For more specific details on your Discussion section, be sure to review Sections 3.8 (pp. 89-90) and 3.16 (pp. 103-104) of your 7 th edition APA manual

*Box content adapted from:

University of Southern California (n.d.). Organizing your social sciences research paper: 8 the discussion . https://libguides.usc.edu/writingguide/discussion

Limitations

Limitations of generalizability or utility of findings, often over which the researcher has no control, should be detailed in your Discussion section. Including limitations for your reader allows you to demonstrate you have thought critically about your given topic, understood relevant literature addressing your topic, and chosen the methodology most appropriate for your research. It also allows you an opportunity to suggest avenues for future research on your topic. An effective limitations section will include the following:

• Detail (a) sources of potential bias, (b) possible imprecision of measures, (c) other limitations or weaknesses of the study, including any methodological or researcher limitations.
• Sample size: In quantitative research, if a sample size is too small, it is more difficult to generalize results.
• Lack of available/reliable data : In some cases, data might not be available or reliable, which will ultimately affect the overall scope of your research. Use this as an opportunity to explain areas for future study.
• Lack of prior research on your study topic: In some cases, you might find that there is very little or no similar research on your study topic, which hinders the credibility and scope of your own research. If this is the case, use this limitation as an opportunity to call for future research. However, make sure you have done a thorough search of the available literature before making this claim.
• Flaws in measurement of data: Hindsight is 20/20, and you might realize after you have completed your research that the data tool you used actually limited the scope or results of your study in some way. Again, acknowledge the weakness and use it as an opportunity to highlight areas for future study.
• Limits of self-reported data: In your research, you are assuming that any participants will be honest and forthcoming with responses or information they provide to you. Simply acknowledging this assumption as a possible limitation is important in your research.
• Access: Most research requires that you have access to people, documents, organizations, etc.. However, for various reasons, access is sometimes limited or denied altogether. If this is the case, you will want to acknowledge access as a limitation to your research.
• Time: Choosing a research focus that is narrow enough in scope to finish in a given time period is important. If such limitations of time prevent you from certain forms of research, access, or study designs, acknowledging this time restraint is important. Acknowledging such limitations is important, as they can point other researchers to areas that require future study.
• Potential Bias: All researchers have some biases, so when reading and revising your draft, pay special attention to the possibilities for bias in your own work. Such bias could be in the form you organized people, places, participants, or events. They might also exist in the method you selected or the interpretation of your results. Acknowledging such bias is an important part of the research process.
• Language Fluency: On occasion, researchers or research participants might have language fluency issues, which could potentially hinder results or how effectively you interpret results. If this is an issue in your research, make sure to acknowledge it in your limitations section.

University of Southern California (n.d.). Organizing your social sciences research paper: Limitations of the study . https://libguides.usc.edu/writingguide/limitations

In many research papers, the conclusion, like the limitations section, is folded into the larger discussion section. If you are unsure whether to include the conclusion as part of your discussion or as a separate section, be sure to defer to the assignment instructions or ask your instructor.

The conclusion is important, as it is specifically designed to highlight your research’s larger importance outside of the specific results of your study. Your conclusion section allows you to reiterate the main findings of your study, highlight their importance, and point out areas for future research. Based on the scope of your paper, your conclusion could be anywhere from one to three paragraphs long. An effective conclusion section should include the following:

• Describe the possibilities for continued research on your topic, including what might be improved, adapted, or added to ensure useful and informed future research.
• Provide a detailed account of the importance of your findings
• Reiterate why your problem is important, detail how your interpretation of results impacts the subfield of study, and what larger issues both within and outside of your field might be affected from such results

University of Southern California (n.d.). Organizing your social sciences research paper: 9. the conclusion . https://libguides.usc.edu/writingguide/conclusion

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• Manuscript Preparation

6 Steps to Write an Excellent Discussion in Your Manuscript

• 4 minute read

Table of Contents

The discussion section in scientific manuscripts might be the last few paragraphs, but its role goes far beyond wrapping up. It’s the part of an article where scientists talk about what they found and what it means, where raw data turns into meaningful insights. Therefore, discussion is a vital component of the article.  

An excellent discussion is well-organized. We bring to you authors a classic 6-step method for writing discussion sections, with examples to illustrate the functions and specific writing logic of each step. Take a look at how you can impress journal reviewers with a concise and focused discussion section!  

Discussion frame structure   

Conventionally, a discussion section has three parts: an introductory paragraph, a few intermediate paragraphs, and a conclusion¹.  Please follow the steps below:  

1.Introduction—mention gaps in previous research¹⁻ ²

Here, you orient the reader to your study. In the first paragraph, it is advisable to mention the research gap your paper addresses.  

Example: This study investigated the cognitive effects of a meat-only diet on adults. While earlier studies have explored the impact of a carnivorous diet on physical attributes and agility, they have not explicitly addressed its influence on cognitively intense tasks involving memory and reasoning.  

2. Summarizing key findings—let your data speak ¹⁻ ²

After you have laid out the context for your study, recapitulate some of its key findings. Also, highlight key data and evidence supporting these findings.  

Example: We found that risk-taking behavior among teenagers correlates with their tendency to invest in cryptocurrencies. Risk takers in this study, as measured by the Cambridge Gambling Task, tended to have an inordinately higher proportion of their savings invested as crypto coins.  

3. Interpreting results—compare with other papers¹⁻²    

Here, you must analyze and interpret any results concerning the research question or hypothesis. How do the key findings of your study help verify or disprove the hypothesis? What practical relevance does your discovery have?  

Example: Our study suggests that higher daily caffeine intake is not associated with poor performance in major sporting events. Athletes may benefit from the cardiovascular benefits of daily caffeine intake without adversely impacting performance.    

Remember, unlike the results section, the discussion ideally focuses on locating your findings in the larger body of existing research. Hence, compare your results with those of other peer-reviewed papers.  

Example: Although Miller et al. (2020) found evidence of such political bias in a multicultural population, our findings suggest that the bias is weak or virtually non-existent among politically active citizens.  

4. Addressing limitations—their potential impact on the results¹⁻²    

Discuss the potential impact of limitations on the results. Most studies have limitations, and it is crucial to acknowledge them in the intermediary paragraphs of the discussion section. Limitations may include low sample size, suspected interference or noise in data, low effect size, etc.  

Example: This study explored a comprehensive list of adverse effects associated with the novel drug ‘X’. However, long-term studies may be needed to confirm its safety, especially regarding major cardiac events.  

5. Implications for future research—how to explore further¹⁻²    

Locate areas of your research where more investigation is needed. Concluding paragraphs of the discussion can explain what research will likely confirm your results or identify knowledge gaps your study left unaddressed.  

Example: Our study demonstrates that roads paved with the plastic-infused compound ‘Y’ are more resilient than asphalt. Future studies may explore economically feasible ways of producing compound Y in bulk.  

6. Conclusion—summarize content¹⁻²    

A good way to wind up the discussion section is by revisiting the research question mentioned in your introduction. Sign off by expressing the main findings of your study.  

Example: Recent observations suggest that the fish ‘Z’ is moving upriver in many parts of the Amazon basin. Our findings provide conclusive evidence that this phenomenon is associated with rising sea levels and climate change, not due to elevated numbers of invasive predators.  

A rigorous and concise discussion section is one of the keys to achieving an excellent paper. It serves as a critical platform for researchers to interpret and connect their findings with the broader scientific context. By detailing the results, carefully comparing them with existing research, and explaining the limitations of this study, you can effectively help reviewers and readers understand the entire research article more comprehensively and deeply¹⁻² , thereby helping your manuscript to be successfully published and gain wider dissemination.  

In addition to keeping this writing guide, you can also use Elsevier Language Services to improve the quality of your paper more deeply and comprehensively. We have a professional editing team covering multiple disciplines. With our profound disciplinary background and rich polishing experience, we can significantly optimize all paper modules including the discussion, effectively improve the fluency and rigor of your articles, and make your scientific research results consistent, with its value reflected more clearly. We are always committed to ensuring the quality of papers according to the standards of top journals, improving the publishing efficiency of scientific researchers, and helping you on the road to academic success. Check us out here !  

Type in wordcount for Standard Total: USD EUR JPY Follow this link if your manuscript is longer than 12,000 words. Upload  

References:   

• Masic, I. (2018). How to write an efficient discussion? Medical Archives , 72(3), 306. https://doi.org/10.5455/medarh.2018.72.306-307  
• Şanlı, Ö., Erdem, S., & Tefik, T. (2014). How to write a discussion section? Urology Research & Practice , 39(1), 20–24. https://doi.org/10.5152/tud.2013.049  

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The discussion section of a research paper is where the author analyzes and explains the importance of the study's results. It presents the conclusions drawn from the study, compares them to previous research, and addresses any potential limitations or weaknesses. The discussion section should also suggest areas for future research.

Everything is not that complicated if you know where to find the required information. We’ll tell you everything there is to know about writing your discussion. Our easy guide covers all important bits, including research questions and your research results. Do you know how all enumerated events are connected? Well, you will after reading this guide we’ve prepared for you!

What Is in the Discussion Section of a Research Paper

The discussion section of a research paper can be viewed as something similar to the conclusion of your paper. But not literal, of course. It’s an ultimate section where you can talk about the findings of your study. Think about these questions when writing:

• Did you answer all of the promised research questions?
• Did you mention why your work matters?
• What are your findings, and why should anyone even care?
• Does your study have a literature review?

So, answer your questions, provide proof, and don’t forget about your promises from the introduction. 

How to Write a Discussion Section in 5 Steps

How to write the discussion section of a research paper is something everyone googles eventually. It's just life. But why not make everything easier? In brief, this section we’re talking about must include all following parts:

• Answers for research questions
• Literature review
• Results of the work
• Limitations of one’s study
• Overall conclusion

Indeed, all those parts may confuse anyone. So by looking at our guide, you'll save yourself some hassle.  P.S. All our steps are easy and explained in detail! But if you are looking for the most efficient solution, consider using professional help. Leave your “ write my research paper for me ” order at StudyCrumb and get a customized study tailored to your requirements.

Step 1. Start Strong: Discussion Section of a Research Paper

First and foremost, how to start the discussion section of a research paper? Here’s what you should definitely consider before settling down to start writing:

• All essays or papers must begin strong. All readers will not wait for any writer to get to the point. We advise summarizing the paper's main findings.
• Moreover, you should relate both discussion and literature review to what you have discovered. Mentioning that would be a plus too.
• Make sure that an introduction or start per se is clear and concise. Word count might be needed for school. But any paper should be understandable and not too diluted.

Step 2. Answer the Questions in Your Discussion Section of a Research Paper

Writing the discussion section of a research paper also involves mentioning your questions. Remember that in your introduction, you have promised your readers to answer certain questions. Well, now it’s a perfect time to finally give the awaited answer. You need to explain all possible correlations between your findings, research questions, and literature proposed. You already had hypotheses. So were they correct, or maybe you want to propose certain corrections? Section’s main goal is to avoid open ends. It’s not a story or a fairytale with an intriguing ending. If you have several questions, you must answer them. As simple as that.

Step 3. Relate Your Results in a Discussion Section

Writing a discussion section of a research paper also requires any writer to explain their results. You will undoubtedly include an impactful literature review. However, your readers should not just try and struggle with understanding what are some specific relationships behind previous studies and your results.  Your results should sound something like: “This guy in their paper discovered that apples are green. Nevertheless, I have proven via experimentation and research that apples are actually red.” Please, don’t take these results directly. It’s just an initial hypothesis. But what you should definitely remember is any practical implications of your study. Why does it matter and how can anyone use it? That’s the most crucial question.

Step 4. Describe the Limitations in Your Discussion Section

Discussion section of a research paper isn’t limitless. What does that mean? Essentially, it means that you also have to discuss any limitations of your study. Maybe you had some methodological inconsistencies. Possibly, there are no particular theories or not enough information for you to be entirely confident in one’s conclusions.  You might say that an available source of literature you have studied does not focus on one’s issue. That’s why one’s main limitation is theoretical. However, keep in mind that your limitations must possess a certain degree of relevancy. You can just say that you haven’t found enough books. Your information must be truthful to research.

Step 5. Conclude Your Discussion Section With Recommendations

Your last step when you write a discussion section in a paper is its conclusion, like in any other academic work. Writer’s conclusion must be as strong as their starting point of the overall work. Check out our brief list of things to know about the conclusion in research paper :

• It must present its scientific relevance and importance of your work.
• It should include different implications of your research.
• It should not, however, discuss anything new or things that you have not mentioned before.
• Leave no open questions and carefully complete the work without them.

Discussion Section of a Research Paper Example

All the best example discussion sections of a research paper will be written according to our brief guide. Don’t forget that you need to state your findings and underline the importance of your work. An undoubtedly big part of one’s discussion will definitely be answering and explaining the research questions. In other words, you’ll already have all the knowledge you have so carefully gathered. Our last step for you is to recollect and wrap up your paper. But we’re sure you’ll succeed!

How to Write a Discussion Section: Final Thoughts

Today we have covered how to write a discussion section. That was quite a brief journey, wasn’t it? Just to remind you to focus on these things:

• Importance of your study.
• Summary of the information you have gathered.
• Main findings and conclusions.
• Answers to all research questions without an open end.
• Correlation between literature review and your results.

But, wait, this guide is not the only thing we can do. Looking for how to write an abstract for a research paper  for example? We have such a blog and much more on our platform.

Our academic writing service is just a click away. We are proud to say that our writers are professionals in their fields. Buy a research paper and our experts can provide prompt solutions without compromising the quality.

Discussion Section of a Research Paper: Frequently Asked Questions

1. how long should the discussion section of a research paper be.

Our discussion section of a research paper should not be longer than other sections. So try to keep it short but as informative as possible. It usually contains around 6-7 paragraphs in length. It is enough to briefly summarize all the important data and not to drag it.

2. What's the difference between the discussion and the results?

The difference between discussion and results is very simple and easy to understand. The results only report your main findings. You stated what you have found and how you have done that. In contrast, one’s discussion mentions your findings and explains how they relate to other literature, research questions, and one’s hypothesis. Therefore, it is not only a report but an efficient as well as proper explanation.

3. What's the difference between a discussion and a conclusion?

The difference between discussion and conclusion is also quite easy. Conclusion is a brief summary of all the findings and results. Still, our favorite discussion section interprets and explains your main results. It is an important but more lengthy and wordy part. Besides, it uses extra literature for references.

4. What is the purpose of the discussion section?

The primary purpose of a discussion section is to interpret and describe all your interesting findings. Therefore, you should state what you have learned, whether your hypothesis was correct and how your results can be explained using other sources. If this section is clear to readers, our congratulations as you have succeeded.

Joe Eckel is an expert on Dissertations writing. He makes sure that each student gets precious insights on composing A-grade academic writing.

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How to Write the Discussion?

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• Atul Kakar 5 &
• Zulfiqar A. Bhutta 6  

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Many authors, and editors, think this is the most difficult part of a paper to write well and have described it variously to be the ‘narrating the story of your research’, ‘the movie or the main scientific script’ and the ‘proof of the pudding’. The idea of a discussion is to communicate to the readers the importance of your observations and the results of all your hard work. In this section, you are expected to infer their meaning and explain the importance of your results and finally provide specific suggestions for future research [1, 2]. The discussion places the outcome into a larger context and mentions the implications of the inferences for theoretical and practical purposes [3].

That then is the first draft and you should never think of having fewer than six drafts Stephen Lock, BMJ editor in chief (1929–…)

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Discussion Section

Discussion: The heart of the paper

Arvind Bagga

Chasing a Dream

1 what is the importance of the discussion.

Many authors, and editors, think this is the most difficult part of a paper to write well and have described it variously to be the ‘narrating the story of your research’, ‘the movie or the main scientific script’ and the ‘proof of the pudding’. The idea of a discussion is to communicate to the readers the importance of your observations and the results of all your hard work. In this section, you are expected to infer their meaning and explain the importance of your results and finally provide specific suggestions for future research [ 1 , 2 ]. The discussion places the outcome into a larger context and mentions the implications of the inferences for theoretical and practical purposes [ 3 ].

2 How Should I Structure the Discussion Section?

There are three major portions for the discussion of a manuscript.

The first paragraph should baldly state the key findings of your research. Use the same key concept you gave in the introduction. It is generally not necessary to repeat the citations which have already been used in the Introduction. According to the ‘serial position effect’, themes mentioned at the beginning and end of a paragraph are more likely to be remembered than those in the middle [ 1 ]. However, one should remember that the discussion should not look like a second introduction, and all the ancillary information which has been previously cited should not be repeated [ 4 ].

For example, in a paper on the ‘Role of sulfasalazine in the Chikungunya arthritis outbreak of 2016’, the review may start with, ‘Our key findings suggest that chikungunya arthralgia is a self-limiting disorder. Persistent arthritis was recorded in only 10% of the affected population and in those who received sulfasalazine, clinical improvement both in tender and swollen joints, was recorded in 95% of the subjects’.

The middle portion should consist of the body of the discussion. This section interprets the important results, discusses their implications and explains how your data is similar to or different from those that have been published previously.

Discuss in fair detail studies supporting your findings and group them together, against those offering a different perspective (e.g., Western experience, smaller numbers, non-randomized studies, etc.). An explanation should be offered on how your work is similar to others or how it is different from the others. This should be followed by a review of the core research papers. The results should now be divided thematically and analyzed. The discussion should also contain why the study is new, why it is true, and why it is important for future clinical practice [ 4 , 5 , 6 ].

For the above research mention the clinical features, patterns of joint involvement, how long arthritis persisted, and any role of disease-modifying agents. Have any other researchers found different findings under the same circumstances.

The final paragraph should include a ‘take home message’ (about one or two) and point to future directions for investigation that have resulted from this study.

The discussion can be concluded in two ways:

By again mentioning the response to the research question [ 5 , 7 ]

By indicating the significance of the study [ 2 , 4 ]

You can use both methods to end this section. Most importantly you should remember that the last paragraph of the discussion should be ‘strong, clear, and crisp’ and focus on the main research question addressed in the manuscript. This should be strengthened by the data which clearly states whether or not your findings support your initial hypothesis [ 1 , 5 , 8 , 9 , 10 ].

3 What Are the General Considerations for Writing a Discussion? [ 3 , 10 , 11 ]

Start the discussion with the ‘specific’ problems and move to the ‘general’ implications (Fig. 21.1 ).

The discussion should not look like a mass of unrelated information. Rather, it should be easy to understand and compare data from different studies.

Include only recent publications on the topic, preferably from the last 10 years.

Make certain that all the sources of information are cited and correctly referenced.

Check to make sure that you have not plagiarized by using words quoted directly from a source.

The written text written should be easily understood, crisp, and brief. Long descriptive and informal language should be avoided.

The sentences should flow smoothly and logically.

You need not refer to all the available literature in the field, discuss only the most relevant papers.

How a discussion should look. First arrow—Mention your key results/findings; Second arrow—Discuss your results with their explanations\step by step; Third Arrow—Enumerate your studies limitations and strengths; Last arrow—Suggest future directions for investigation

4 Discussion Is Not a War of Words

5 How Long Should the Discussion in the Manuscript Be?

Most journals do not mention any limits for discussion as long as it is brief and relevant (Fig. 21.2 ). As a rule, ‘The length of the discussion section should not exceed the sum of other parts-introduction, materials and methods, and results’. [ 3 ] In any good article, the discussion section is 3–4 pages, 6–7 paragraphs, or approximately 10 paragraphs, and 1000–1500 words [ 1 , 5 , 8 , 12 ].

Discussion pyramid

6 What Should Be Written in the Conclusion Section?

The conclusion is the last paragraph and has the carry-home message for the reader. It is the powerful and meaningful end piece of the script. It states what change has the paper made to science and it also contains recommendations for future studies.

7 Conclusions

Discussion is not a stand-alone section, it intertwines the objectives of the study with how and what was achieved.

The major results are described and compared with other studies.

The author’s own work is critically analysed in comparison with that of others.

The limitations and strengths of the study are highlighted.

Masic I. How to write an efficient discussion? Mediev Archaeol. 2018;72(4):306–7.

Google Scholar  

Bagga A. Discussion: the heart of the paper. Indian Pediatr. 2016;53(10):901–4.

Article   Google Scholar  

Ghasemi A, Bahadoran Z, Mirmiran P, Hosseinpanah F, Shiva N, Zadeh-Vakili A. The principles of biomedical scientific writing: discussion. Int J Endocrinol Metab. 2019;17:e95415.

Zeiger M. Essentials of writing biomedical research papers. Canadian J Stud Discourse Writing. 2000;11:33–6.

Bavdekar SB. Writing the discussion section: describing the significance of the study findings. J Assoc Physicians India. 2015;63:40–2.

PubMed   Google Scholar  

Foote M. The proof of the pudding: how to report results and write a good discussion. Chest. 2009;135(3):866–8.

Alexandrov AV. How to write a research paper? Cerebrovasc Dis. 2004;18(2):135–8.

Annesley TM. The discussion section: your closing argument. Clin Chem. 2010;56(11):1671–4.

Article   CAS   Google Scholar  

Ng KH, Peh WC. Writing the discussion. Singap Med J. 2009;50:458–60.

CAS   Google Scholar  

Coverdale JH, Roberts LW, Balon R, Beresin EV. Writing for academia: Getting your research into print: AMEE guide No. 74. Med Teach. 2013;35:e926–34.

Araujo CG. Detailing the writing of scientific manuscripts: 25–30 paragraphs. Arq Bras Cardiol. 2014;102(2):e21–3.

PubMed   PubMed Central   Google Scholar  

Kearney MH. The discussion section tells us where we are. Res Nurs Health. 2017;40(4):289–91.

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Nundy, S., Kakar, A., Bhutta, Z.A. (2022). How to Write the Discussion?. In: How to Practice Academic Medicine and Publish from Developing Countries?. Springer, Singapore. https://doi.org/10.1007/978-981-16-5248-6_21

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How to Write a Discussion Section | Tips & Examples

Published on 21 August 2022 by Shona McCombes . Revised on 25 October 2022.

The discussion section is where you delve into the meaning, importance, and relevance of your results .

It should focus on explaining and evaluating what you found, showing how it relates to your literature review , and making an argument in support of your overall conclusion . It should not be a second results section .

There are different ways to write this section, but you can focus your writing around these key elements:

• Summary: A brief recap of your key results
• Interpretations: What do your results mean?
• Implications: Why do your results matter?
• Limitations: What can’t your results tell us?
• Recommendations: Avenues for further studies or analyses

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What not to include in your discussion section, step 1: summarise your key findings, step 2: give your interpretations, step 3: discuss the implications, step 4: acknowledge the limitations, step 5: share your recommendations, discussion section example.

There are a few common mistakes to avoid when writing the discussion section of your paper.

• Don’t introduce new results: You should only discuss the data that you have already reported in your results section .
• Don’t make inflated claims: Avoid overinterpretation and speculation that isn’t directly supported by your data.
• Don’t undermine your research: The discussion of limitations should aim to strengthen your credibility, not emphasise weaknesses or failures.

Prevent plagiarism, run a free check.

Start this section by reiterating your research problem  and concisely summarising your major findings. Don’t just repeat all the data you have already reported – aim for a clear statement of the overall result that directly answers your main  research question . This should be no more than one paragraph.

Many students struggle with the differences between a discussion section and a results section . The crux of the matter is that your results sections should present your results, and your discussion section should subjectively evaluate them. Try not to blend elements of these two sections, in order to keep your paper sharp.

• The results indicate that …
• The study demonstrates a correlation between …
• This analysis supports the theory that …
• The data suggest  that …

The meaning of your results may seem obvious to you, but it’s important to spell out their significance for your reader, showing exactly how they answer your research question.

The form of your interpretations will depend on the type of research, but some typical approaches to interpreting the data include:

• Identifying correlations , patterns, and relationships among the data
• Discussing whether the results met your expectations or supported your hypotheses
• Contextualising your findings within previous research and theory
• Explaining unexpected results and evaluating their significance
• Considering possible alternative explanations and making an argument for your position

You can organise your discussion around key themes, hypotheses, or research questions, following the same structure as your results section. Alternatively, you can also begin by highlighting the most significant or unexpected results.

• In line with the hypothesis …
• Contrary to the hypothesised association …
• The results contradict the claims of Smith (2007) that …
• The results might suggest that x . However, based on the findings of similar studies, a more plausible explanation is x .

As well as giving your own interpretations, make sure to relate your results back to the scholarly work that you surveyed in the literature review . The discussion should show how your findings fit with existing knowledge, what new insights they contribute, and what consequences they have for theory or practice.

Ask yourself these questions:

• Do your results support or challenge existing theories? If they support existing theories, what new information do they contribute? If they challenge existing theories, why do you think that is?
• Are there any practical implications?

Your overall aim is to show the reader exactly what your research has contributed, and why they should care.

• These results build on existing evidence of …
• The results do not fit with the theory that …
• The experiment provides a new insight into the relationship between …
• These results should be taken into account when considering how to …
• The data contribute a clearer understanding of …
• While previous research has focused on  x , these results demonstrate that y .

Even the best research has its limitations. Acknowledging these is important to demonstrate your credibility. Limitations aren’t about listing your errors, but about providing an accurate picture of what can and cannot be concluded from your study.

Limitations might be due to your overall research design, specific methodological choices , or unanticipated obstacles that emerged during your research process.

Here are a few common possibilities:

• If your sample size was small or limited to a specific group of people, explain how generalisability is limited.
• If you encountered problems when gathering or analysing data, explain how these influenced the results.
• If there are potential confounding variables that you were unable to control, acknowledge the effect these may have had.

After noting the limitations, you can reiterate why the results are nonetheless valid for the purpose of answering your research question.

• The generalisability of the results is limited by …
• The reliability of these data is impacted by …
• Due to the lack of data on x , the results cannot confirm …
• The methodological choices were constrained by …
• It is beyond the scope of this study to …

Based on the discussion of your results, you can make recommendations for practical implementation or further research. Sometimes, the recommendations are saved for the conclusion .

Suggestions for further research can lead directly from the limitations. Don’t just state that more studies should be done – give concrete ideas for how future work can build on areas that your own research was unable to address.

• Further research is needed to establish …
• Future studies should take into account …
• Avenues for future research include …

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Writing a discussion section: how to integrate substantive and statistical expertise

Michael höfler.

1 Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

5 Chair of Clinical Psychology and Behavioural Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

2 Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

Sebastian Trautmann

Robert miller.

3 Faculty of Psychology, Technische Universität Dresden, Dresden, Germany

4 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden

Associated Data

Not applicable.

When discussing results medical research articles often tear substantive and statistical (methodical) contributions apart, just as if both were independent. Consequently, reasoning on bias tends to be vague, unclear and superficial. This can lead to over-generalized, too narrow and misleading conclusions, especially for causal research questions.

To get the best possible conclusion, substantive and statistical expertise have to be integrated on the basis of reasonable assumptions. While statistics should raise questions on the mechanisms that have presumably created the data, substantive knowledge should answer them. Building on the related principle of Bayesian thinking, we make seven specific and four general proposals on writing a discussion section.

Misinterpretation could be reduced if authors explicitly discussed what can be concluded under which assumptions. Informed on the resulting conditional conclusions other researchers may, according to their knowledge and beliefs, follow a particular conclusion or, based on other conditions, arrive at another one. This could foster both an improved debate and a better understanding of the mechanisms behind the data and should therefore enable researchers to better address bias in future studies.

After a research article has presented the substantive background, the methods and the results, the discussion section assesses the validity of results and draws conclusions by interpreting them. The discussion puts the results into a broader context and reflects their implications for theoretical (e.g. etiological) and practical (e.g. interventional) purposes. As such, the discussion contains an article’s last words the reader is left with.

Common recommendations for the discussion section include general proposals for writing [ 1 ] and structuring (e.g. with a paragraph on a study’s strengths and weaknesses) [ 2 ], to avoid common statistical pitfalls (like misinterpreting non-significant findings as true null results) [ 3 ] and to “go beyond the data” when interpreting results [ 4 ]. Note that the latter includes much more than comparing an article’s results with the literature. If results and literature are consistent, this might be due to shared bias only. If they are not consistent, the question arises why inconsistency occurs – maybe because of bias acting differently across studies [ 5 – 7 ]. Recommendations like the CONSORT checklist do well in demanding all quantitative information on design, participation, compliance etc. to be reported in the methods and results section and “addressing sources of potential bias”, “limitations” and “considering other relevant evidence” in the discussion [ 8 , 9 ]. Similarly, the STROBE checklist for epidemiological research demands “a cautious overall interpretation of results” and "discussing the generalizability (external validity)" [ 10 , 11 ]. However, these guidelines do not clarify how to deal with the complex bias issue, and how to get to and report conclusions.

Consequently, suggestions on writing a discussion often remain vague by hardly addressing the role of the assumptions that have (often implicitly) been made when designing a study, analyzing the data and interpreting the results. Such assumptions involve mechanisms that have created the data and are related to sampling, measurement and treatment assignment (in observational studies common causes of factor and outcome) and, as a consequence, the bias this may produce [ 5 , 6 ]. They determine whether a result allows only an associational or a causal conclusion. Causal conclusions, if true, are of much higher relevance for etiology, prevention and intervention. However, they require much stronger assumptions. These have to be fully explicit and, therewith, essential part of the debate since they always involve subjectivity. Subjectivity is unavoidable because the mechanisms behind the data can never be fully estimated from the data themselves [ 12 ].

In this article, we argue that the conjunction of substantive and statistical (methodical) knowledge in the verbal integration of results and beliefs on mechanisms can be greatly improved in (medical) research papers. We illustrate this through the personal roles that a statistician (i.e. methods expert) and a substantive researcher should take. Doing so, we neither claim that usually just two people write a discussion, nor that one person lacks the knowledge of the other, nor that there were truly no researchers that have both kinds of expertise. As a metaphor, the division of these two roles into two persons describes the necessary integration of knowledge via the mode of a dialogue. Verbally, it addresses the finding of increased specialization of different study contributors in biomedical research. This has teared apart the two processes of statistical compilation of results and their verbal integration [ 13 ]. When this happens a statistician alone is limited to a study’s conditions (sampled population, experimental settings etc.), because he or she is unaware of the conditions’ generalizability. On the other hand, a A substantive expert alone is prone to over-generalize because he or she is not aware of the (mathematical) prerequisites for an interpretation.

The article addresses both (medical) researchers educated in basic statistics and research methods and statisticians who cooperate with them. Throughout the paper we exemplify our arguments with the finding of an association in a cross-tabulation between a binary X (factor) and a binary Y (outcome): those who are exposed to or treated with X have a statistically significantly elevated risk for Y as compared to the non-exposed or not (or otherwise) treated (for instance via the chi-squared independence test or logistic regression). Findings like this are frequent and raise the question which more profound conclusion is valid under what assumptions. Until some decades ago, statistics has largely avoided the related topic of causality and instead limited itself on describing observed distributions (here a two-by-two table between D = depression and LC = lung cancer) with well-fitting models.

We illustrate our arguments with the concrete example of the association found between the factor depression (D) and the outcome lung cancer (LC) [ 14 ]. Yet very different mechanisms could have produced such an association [ 7 ], and assumptions on these lead to the following fundamentally different conclusions (Fig. ​ (Fig.1 1 ):

• D causes LC (e.g. because smoking might constitute “self-medication” of depression symptoms)
• LC causes D (e.g. because LC patients are demoralized by their diagnosis)
• D and LC cause each other (e.g. because the arguments in both a. and b. apply)
• D and LC are the causal consequence of the same factor(s) (e.g. poor health behaviors - HB)
• D and LC only share measurement error (e.g. because a fraction of individuals that has either depression or lung cancer denies both in self-report measures).

Different conclusions about an association between D and LC. a D causes LC, b LC causes B, c D and LC cause each other, d D and LC are associated because of a shared factor (HB), e D and LC are associated because they have correlated errors

Note that we use the example purely for illustrative purposes. We do not make substantive claims on what of a. through e. is true but show how one should reflect on mechanisms in order to find the right answer. Besides, we do not consider research on the D-LC relation apart from the finding of association [ 14 ].

Assessing which of a. through e. truly applies requires substantive assumptions on mechanisms: the temporal order of D and LC (a causal effect requires that the cause occurs before the effect), shared factors, selection processes and measurement error. Questions on related mechanisms have to be brought up by statistical consideration, while substantive reasoning has to address them. Together this yields provisional assumptions for inferring that are subject to readers’ substantive consideration and refinement. In general, the integration of prior beliefs (anything beyond the data a conclusion depends on) and the results from the data themselves is formalized by Bayesian statistics [ 15 , 16 ]. This is beyond the scope of this article, still we argue that Bayesian thinking should govern the process of drawing conclusions.

Building on this idea, we provide seven specific and four general recommendations for the cooperative process of writing a discussion. The recommendations are intended to be suggestions rather than rules. They should be subject to further refinement and adjustment to specific requirements in different fields of medical and other research. Note that the order of the points is not meant to structure a discussion’s writing (besides 1.).

Recommendations for writing a discussion section

Specific recommendations.

Consider the example on the association between D and LC. Rather than starting with an in-depth (causal) interpretation a finding should firstly be taken as what it allows inferring without doubt: Under the usual assumptions that a statistical model makes (e.g. random sampling, independence or certain correlation structure between observations [ 17 ]), the association indicates that D (strictly speaking: measuring D) predicts an elevated LC risk (strictly speaking: measuring LC) in the population that one has managed to sample (source population). Assume that the sample has been randomly drawn from primary care settings. In this case the association is useful to recommend medical doctors to better look at an individual’s LC risk in case of D. If the association has been adjusted for age and gender (conveniently through a regression model), the conclusion modifies to: If the doctor knows a patient’s age and gender (what should always be the case) D has additional value in predicting an elevated LC risk.

In the above example, a substantive researcher might want to conclude that D and LC are associated in a general population instead of just inferring to patients in primary care settings (a.). Another researcher might even take the finding as evidence for D being a causal factor in the etiology of LC, meaning that prevention of D could reduce the incidence rate of LC (in whatever target population) (b.). In both cases, the substantive researcher should insist on assessing the desired interpretation that goes beyond the data [ 4 ], but the statistician immediately needs to bring up the next point.

The explanation of all the assumptions that lead from a data result to a conclusion enables a reader to assess whether he or she agrees with the authors’ inference or not. These conditions, however, often remain incomplete or unclear, in which case the reader can hardly assess whether he or she follows a path of argumentation and, thus, shares the conclusion this path leads to.

Consider conclusion a. and suppose that, instead of representative sampling in a general population (e.g. all U.S. citizens aged 18 or above), the investigators were only able to sample in primary care settings. Extrapolating the results to another population than the source population requires what is called “external validity”, “transportability” or the absence of “selection bias” [ 18 , 19 ]. No such bias occurs if the parameter of interest is equal in the source and the target population. Note that this is a weaker condition than the common belief that the sample must represent the target population in everything . If the parameter of interest is the difference in risk for LC between cases and non-cases of D, the condition translates into: the risk difference must be equal in target and source population.

For the causal conclusion b., however, sufficient assumptions are very strict. In an RCT, the conclusion is valid under random sampling from the target population, random allocation of X, perfect compliance in X, complete participation and no measurement error in outcome (for details see [ 20 ]). In practice, on the other hand, the derivations from such conditions might sometimes be modest what may produce little bias only. For instance, non-compliance in a specific drug intake (treatment) might occur only in a few individuals to little extent through a random process (e.g. sickness of a nurse being responsible for drug dispense) and yield just small (downward) bias [ 5 ]. The conclusion of downward bias might also be justified if non-compliance does not cause anything that has a larger effect on a Y than the drug itself. Another researcher, however, could believe that non-compliance leads to taking a more effective, alternative treatment. He or she could infer upward bias instead if well-informed on the line of argument.

In practice, researchers frequently use causal language yet without mentioning any assumptions. This does not imply that they truly have a causal effect in mind, often causal and associational wordings are carelessly used in synonymous way. For example, concluding “depression increases the risk of lung cancer” constitutes already causal wording because it implies that a change in the depression status would change the cancer risk. Associational language like “lung cancer risk is elevated if depression occurs”, however, would allow for an elevated lung cancer risk in depression cases just because LC and D share some causes (“inducing” or “removing” depression would not change the cancer risk here).

Often, it is unclear where the path of argumentation from assumptions to a conclusion leads when alternative assumptions are made. Consider again bias due to selection. A different effect in target and source population occurs if effect-modifying variables distribute differently in both populations. Accordingly, the statistician should ask which variables influence the effect of interest, and whether these can be assumed to distribute equally in the source population and the target population. The substantive researcher might answer that the causal risk difference between D and LC likely increases with age. Given that this is true, and if elder individuals have been oversampled (e.g. because elderly are over-represented in primary care settings), both together would conclude that sampling has led to over-estimation (despite other factors, Fig. ​ Fig.2 2 ).

If higher age is related to a larger effect (risk difference) of D on LC, a larger effect estimate is expected in an elder sample

However, the statistician might add, if effect modification is weak, or the difference in the age distributions is modest (e.g. mean 54 vs. 52 years), selection is unlikely to have produced large (here: upward) bias. In turn, another substantive researcher, who reads the resulting discussion, might instead assume a decrease of effect with increasing age and thus infer downward bias.

In practice, researchers should be extremely sensitive for bias due to selection if a sample has been drawn conditionally on a common consequence of factor and outcome or a variable associated with such a consequence [19 and references therein]. For instance, hospitalization might be influenced by both D and LC, and thus sampling from hospitals might introduce a false association or change an association’s sign; particularly D and LC may appear to be negatively associated although the association is positive in the general population (Fig. ​ (Fig.3 3 ).

If hospitalization (H) is a common cause of D and LC, sampling conditionally on H can introduce a spurious association between D and LC ("conditioning on a collider")

Usually, only some kinds of bias are discussed, while the consequences of others are ignored [ 5 ]. Besides selection the main sources of bias are often measurement and confounding. If one is only interested in association, confounding is irrelevant. For causal conclusions, however, assumptions on all three kinds of bias are necessary.

Measurement error means that the measurement of a factor and/or outcome deviates from the true value, at least in some individuals. Bias due to measurement is known under many other terms that describe the reasons why such error occurs (e.g. “recall bias” and “reporting bias”). In contrast to conventional wisdom, measurement error does not always bias association and effect estimates downwards [ 5 , 6 ]. It does, for instance, if only the factor (e.g. depression) is measured with error and the errors occur independently from the outcome (e.g. lung cancer), or vice versa (“non-differential misclassification”) [22 and references therein]. However, many lung cancer cases might falsely report depression symptoms (e.g. to express need for care). Such false positives (non-cases of depression classified as cases) may also occur in non-cases of lung cancer but to a lesser extent (a special case of “differential misclassification”). Here, bias might be upward as well. Importantly, false positives cause larger bias than false negatives (non-cases of depression falsely classified as depression cases) as long as the relative frequency of a factor is lower than 50% [ 21 ]. Therefore, they should receive more attention in discussion. If measurement error occurs in depression and lung cancer, the direction of bias also depends on the correlation between both errors [ 21 ].

Note that what is in line with common standards of “good” measurement (e.g. a Kappa value measuring validity or reliability of 0.7) might anyway produce large bias. This applies to estimates of prevalence, association and effect. The reason is that while indices of measurement are one-dimensional, bias depends on two parameters (sensitivity and specificity) [ 21 , 22 ]. Moreover, estimates of such indices are often extrapolated to different kinds of populations (typically from a clinical to general population), what may be inadequate. Note that the different kinds of bias often interact, e.g. bias due to measurement might depend on selection (e.g. measurement error might differ between a clinical and a general population) [ 5 , 6 ].

Assessment of bias due to confounding variables (roughly speaking: common causes of factor and outcome) requires assumptions on the entire system of variables that affect both factor and outcome. For example, D and LC might share several causes such as stressful life events or socioeconomic status. If these influence D and LC with the same effect direction, this leads to overestimation, otherwise (different effect directions) the causal effect is underestimated. In the medical field, many unfavorable conditions may be positively related. If this holds true for all common factors of D and LC, upward bias can be assumed. However, not all confounders have to be taken into account. Within the framework of “causal graphs”, the “backdoor criterion” [ 7 ] provides a graphical rule for sets of confounders to be sufficient when adjusted for. Practically, such a causal graph must include all factors that directly or indirectly affect both D and LC. Then, adjustment for a set of confounders that meets the “backdoor criterion” in the graph completely removes bias due to confounding. In the example of Fig. ​ Fig.4 4 it is sufficient to adjust for Z 1 and Z 2 because this “blocks” all paths that otherwise lead backwards from D to LC. Note that fully eliminating bias due to confounding also requires that the confounders have been collected without measurement error [ 5 , 6 , 23 ]. Therefore, the advice is always to concede at least some “residual” bias and reflect on the direction this might have (could be downward if such error is not stronger related to D and LC than a confounder itself).

Causal graph for the effect of D on LC and confounders Z 1 , Z 2 and Z 3

Whereas the statistician should pinpoint to the mathematical insight of the backdoor criterion, its application requires profound substantive input and literature review. Of course, there are numerous relevant factors in the medical field. Hence, one should practically focus on those with the highest prevalence (a very seldom factor can hardly cause large bias) and large assumed effects on both X and Y.

If knowledge on any of the three kinds of bias is poor or very uncertain, researchers should admit that this adds uncertainty in a conclusion: systematic error on top of random error. In the Bayesian framework, quantitative bias analysis formalizes this through the result of larger variance in an estimate. Technically, this additional variance is introduced via the variances of distributions assigned to “bias parameters”; for instance a misclassification probability (e.g. classifying a true depression case as non-case) or the prevalence of a binary confounder and its effects on X and Y. Of course, bias analysis also changes point estimates (hopefully reducing bias considerably). Note that conventional frequentist analysis, as regarded from the Bayesian perspective, assumes that all bias parameters were zero with a probability of one [ 5 , 6 , 23 ]. The only exceptions (bias addressed in conventional analyses) are adjustment on variables to hopefully reduce bias due to confounding and weighting the individuals (according to variables related to participation) to take into account bias due to selection.

If the substantive investigator understands the processes of selection, measurement and confounding only poorly, such strict analysis numerically reveals that little to nothing is known on the effect of X on Y, no matter how large an observed association and a sample (providing small random error) may be [ 5 , 6 , 23 ]). This insight has to be brought up by the statistician. Although such an analysis is complicated, itself very sensitive to how it is conducted [ 5 , 6 ] and rarely done, the Bayesian thinking behind it forces researchers to better understand the processes behind the data. Otherwise, he or she cannot make any assumptions and, in turn, no conclusion on causality.

Usually articles end with statements that only go little further than the always true but never informative statement “more research is needed”. Moreover, larger samples and better measurements are frequently proposed. If an association has been found, a RCT or other interventional study is usually proposed to investigate causality. In our example, this recommendation disregards that: (1) onset of D might have a different effect on LC risk than an intervention against D (the effect of onset cannot be investigated in any interventional study), (2) the effects of onset and intervention concern different populations (those without vs. those with depression), (3) an intervention effect depends on the mode of intervention [ 24 ], and (4) (applying the backdoor criterion) a well-designed observational study may approximatively yield the same result as a randomized study would [ 25 – 27 ]. If the effect of “removing” depression is actually of interest, one could propose an RCT that investigates the effect of treating depression in a strictly defined way and in a strictly defined population (desirably in all who meet the criteria of depression). Ideally, this population is sampled randomly, and non-participants and dropouts are investigated with respect to assumed effect-modifiers (differences in their distributions between participants and non-participants can then be addressed e.g. by weighting [ 27 ]). In a non-randomized study, one should collect variables supposed to meet the backdoor-criterion with the best instruments possible.

General recommendations

Yet when considering 1) through 7); i.e. carefully reflecting on the mechanisms that have created the data, discussions on statistical results can be very misleading, because the basic statistical methods are mis-interpreted or inadequately worded.

A common pitfall is to consider the lack of evidence for the alternative hypothesis (e.g. association between D and LC) as evidence for the null hypothesis (no association). In fact, such inference requires an a-priori calculated sample-size to ensure that the type-two error probability does not exceed a pre-specified limit (typically 20% or 10%, given the other necessary assumptions, e.g. on the true magnitude of association). Otherwise, the type-two error is unknown and in practice often large. This may put a “false negative result” into the scientific public that turns out to be “unreplicable” – what would be falsely interpreted as part of the “replication crisis”. Such results are neither positive nor negative but uninformative . In this case, the wording “there is no evidence for an association” is adequate because it does not claim that there is no association.

Frequently, it remains unclear which hypotheses have been a-priori specified and which have been brought up only after some data analysis. This, of course, is scientific malpractice because it does not enable the readership to assess the random error emerging from explorative data analysis. Accordingly, the variance of results across statistical methods is often misused to filter out the analysis that yields a significant result (“ p -hacking”, [ 28 ]). Pre-planned tests (via writing a grant) leave at least less room for p-hacking because they specify a-priori which analysis is to be conducted.

On the other hand, post-hoc analyses can be extremely useful for identifying unexpected phenomena and creating new hypotheses. Verbalization in the discussion section should therefore sharply separate between conclusions from hypothesis testing and new hypotheses created from data exploration. The distinction is profound, since a newly proposed hypothesis just makes a new claim. Suggesting new hypotheses cannot be wrong, this can only be inefficient if many hypotheses turn out to be wrong. Therefore, we suggest proposing only a limited number of new hypotheses that appear promising to stimulate further research and scientific progress. They are to be confirmed or falsified with future studies. A present discussion, however, should yet explicate the testable predictions a new hypothesis entails, and how a future study should be designed to keep bias in related analyses as small as possible.

Confidence intervals address the problem of reducing results to the dichotomy of significant and non-significant through providing a range of values that are compatible with the data at the given confidence level, usually 95% [ 29 ].

This is also addressed by Bayesian statistics that allows calculating what frequentist p -values are often misinterpreted to be: the probability that the alternative (or null) hypothesis is true [ 17 ]. Moreover, one can calculate how likely it is that the parameter lies within any specified range (e.g. the risk difference being greater than .05, a lower boundary for practical significance) [ 15 , 16 ]. To gain these benefits, one needs to specify how the parameter of interest (e.g. causal risk difference between D and LC) is distributed before inspecting the data. In Bayesian statistics (unlike frequentist statistics) a parameter is a random number that expresses prior beliefs via a “prior distribution”. Such a “prior” is combined with the data result to a “posterior distribution”. This integrates both sources of information.

Note that confidence intervals also can be interpreted from the Bayesian perspective (then called “credibility interval”). This assumes that all parameter values were equally likely (uniformly distributed, strictly speaking) before analyzing the data [ 5 , 6 , 20 ].

Testing just for a non-zero association can only yield evidence for an association deviating from zero. A better indicator for the true impact of an effect/association for clinical, economic, political, or research purposes is its magnitude. If an association between D and LC after adjusting for age and gender has been discovered, then the knowledge of D has additional value in predicting an elevated LC probability beyond age and gender. However, there may be many other factors that stronger predict LC and thus should receive higher priority in a doctor’s assessment. Besides, if an association is small, it may yet be explained by modest (upward) bias. Especially large samples often yield significant results with little practical value. The p -value does not measure strength of association [ 17 ]. For instance, in a large sample, a Pearson correlation between two dimensional variables could equal 0.1 only but with a p -value <.001. A further problem arises if the significance threshold of .05 is weakened post-hoc to allow for “statistical trends” ( p between .05 and .10) because a result has “failed to reach significance” (this wording claims that there is truly an association. If this was known, no research would be necessary).

It is usually the statistician’s job to insist not only on removing the attention from pure statistical significance to confidence intervals or even Bayesian interpretation, but also to point out the necessity of a meaningful cutoff for practical significance. The substantive researcher then has to provide this cutoff.

Researchers should not draw conclusions that have not been explicitly tested for. For example, one may have found a positive association between D and LC (e.g. p  = .049), but this association is not significant (e.g. p  = .051), when adjusting for “health behavior”. This does not imply that “health behavior” “explains” the association (yet fully). The difference in magnitude of association in both analyses compared here (without and with adjustment on HB) may be very small and the difference in p -values (“borderline significance” after adjustment) likely to emerge from random error. This often applies to larger differences in p as well.

Investigators, however, might find patterns in their results that they consider worth mentioning for creating hypotheses. In the example above, adding the words “in the sample”, would clarify that they refer just to the difference of two point estimates . By default, “association” in hypotheses testing should mean “statistically significant association” (explorative analyses should instead refer to “suggestive associations”).

Conclusions

Some issues of discussing results not mentioned yet appear to require only substantive reasoning. For instance, Bradford Hill’s consideration on “plausibility” claims that a causal effect is more likely, if it is in line with biological (substantive) knowledge, or if a dose-response relation has been found [ 30 ]. However, the application of these considerations itself depends on the trueness of assumptions. For instance, bias might act differently across the dose of exposure (e.g. larger measurement error in outcome among those with higher dosage). As a consequence, a pattern observed across dose may mask a true or pretend a wrong dose-response relation [ 30 ]. This again has to be brought up by statistical expertise.

There are, however, some practical issues that hinder the cooperation we suggest. First, substantive researchers often feel discomfort when urged to make assumptions on the mechanisms behind the data, presumably because they fear to be wrong. Here, the statistician needs to insist: “If you are unable to make any assumptions, you cannot conclude anything!” And: “As a scientist you have to understand the processes that create your data.” See [ 31 ] for practical advice on how to arrive at meaningful assumptions.

Second, statisticians have long been skeptical against causal inference. Still, most of them focus solely on describing observed data with distributional models, probably because estimating causal effects has long been regarded as unfeasible with scientific methods. Training in causality remains rather new, since strict mathematical methods have been developed only in the last decades [ 7 ].

The cooperation could be improved if education in both fields focused on the insight that one cannot succeed without the other. Academic education should demonstrate that in-depth conclusions from data unavoidably involve prior beliefs. Such education should say: Data do not “speak for themselves”, because they “speak” only ambiguously and little, since they have been filtered through various biases [ 32 ]. The subjectivity introduced by addressing bias, however, unsettles many researchers. On the other hand, conventional frequentist statistics just pretends to be objective. Instead of accepting the variety of possible assumptions, it makes the absurd assumption of “no bias with probability of one”. Or it avoids causal conclusions at all if no randomized study is possible. This limits science to investigating just associations for all factors that can never be randomized (e.g. onset of depression). However, the alternative of Bayesian statistics and thinking are themselves prone to fundamental cognitive biases which should as well be subject of interdisciplinary teaching [ 33 ].

Readers may take this article as an invitation to read further papers’ discussions differently while evaluating our claims. Rather than sharing a provided conclusion (or not) they could ask themselves whether a discussion enables them to clearly specify why they share it (or not). If the result is uncertainty, this might motivate them to write their next discussion differently. The proposals made in this article could help shifting scientific debates to where they belong. Rather than arguing on misunderstandings caused by ambiguity in a conclusion’s assumptions one should argue on the assumptions themselves.

Acknowledgements

We acknowledge support by the German Research Foundation and the Open Access Publication Funds of the TU Dresden. We wish to thank Pia Grabbe and Helen Steiner for language editing and the cited authors for their outstanding work that our proposals build on.

John Venz is funded by the German Federal Ministry of Education and Research (BMBF) project no. 01ER1303 and 01ER1703. He has contributed to this manuscript outside of time funded by these projects.

Availability of data and materials

Abbreviations, authors’ contributions.

MH and RM had the initial idea on the article. MH has taken the lead in writing. JV has contributed to the statistical parts, especially the Bayesian aspects. RM has refined the paragraphs on statistical inference. ST joined later and has added many clarifications related to the perspective of the substantive researcher. All authors have contributed to the final wording of all sections and the article’s revision. All authors read and approved the final manuscript.

Ethics approval and consent to participate

Consent for publication, competing interests.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Frequently asked questions

What’s the difference between results and discussion.

The results chapter or section simply and objectively reports what you found, without speculating on why you found these results. The discussion interprets the meaning of the results, puts them in context, and explains why they matter.

In qualitative research , results and discussion are sometimes combined. But in quantitative research , it’s considered important to separate the objective results from your interpretation of them.

Frequently asked questions: Dissertation

Dissertation word counts vary widely across different fields, institutions, and levels of education:

• An undergraduate dissertation is typically 8,000–15,000 words
• A master’s dissertation is typically 12,000–50,000 words
• A PhD thesis is typically book-length: 70,000–100,000 words

However, none of these are strict guidelines – your word count may be lower or higher than the numbers stated here. Always check the guidelines provided by your university to determine how long your own dissertation should be.

A dissertation prospectus or proposal describes what or who you plan to research for your dissertation. It delves into why, when, where, and how you will do your research, as well as helps you choose a type of research to pursue. You should also determine whether you plan to pursue qualitative or quantitative methods and what your research design will look like.

It should outline all of the decisions you have taken about your project, from your dissertation topic to your hypotheses and research objectives , ready to be approved by your supervisor or committee.

Note that some departments require a defense component, where you present your prospectus to your committee orally.

A thesis is typically written by students finishing up a bachelor’s or Master’s degree. Some educational institutions, particularly in the liberal arts, have mandatory theses, but they are often not mandatory to graduate from bachelor’s degrees. It is more common for a thesis to be a graduation requirement from a Master’s degree.

Even if not mandatory, you may want to consider writing a thesis if you:

• Plan to attend graduate school soon
• Have a particular topic you’d like to study more in-depth
• Are considering a career in research
• Would like a capstone experience to tie up your academic experience

The conclusion of your thesis or dissertation should include the following:

• A restatement of your research question
• A summary of your key arguments and/or results
• A short discussion of the implications of your research

The conclusion of your thesis or dissertation shouldn’t take up more than 5–7% of your overall word count.

For a stronger dissertation conclusion , avoid including:

• Important evidence or analysis that wasn’t mentioned in the discussion section and results section
• Generic concluding phrases (e.g. “In conclusion …”)
• Weak statements that undermine your argument (e.g., “There are good points on both sides of this issue.”)

Your conclusion should leave the reader with a strong, decisive impression of your work.

While it may be tempting to present new arguments or evidence in your thesis or disseration conclusion , especially if you have a particularly striking argument you’d like to finish your analysis with, you shouldn’t. Theses and dissertations follow a more formal structure than this.

All your findings and arguments should be presented in the body of the text (more specifically in the discussion section and results section .) The conclusion is meant to summarize and reflect on the evidence and arguments you have already presented, not introduce new ones.

A theoretical framework can sometimes be integrated into a  literature review chapter , but it can also be included as its own chapter or section in your dissertation . As a rule of thumb, if your research involves dealing with a lot of complex theories, it’s a good idea to include a separate theoretical framework chapter.

A literature review and a theoretical framework are not the same thing and cannot be used interchangeably. While a theoretical framework describes the theoretical underpinnings of your work, a literature review critically evaluates existing research relating to your topic. You’ll likely need both in your dissertation .

While a theoretical framework describes the theoretical underpinnings of your work based on existing research, a conceptual framework allows you to draw your own conclusions, mapping out the variables you may use in your study and the interplay between them.

A thesis or dissertation outline is one of the most critical first steps in your writing process. It helps you to lay out and organize your ideas and can provide you with a roadmap for deciding what kind of research you’d like to undertake.

Generally, an outline contains information on the different sections included in your thesis or dissertation , such as:

• Your anticipated title
• Your abstract
• Your chapters (sometimes subdivided into further topics like literature review , research methods , avenues for future research, etc.)

When you mention different chapters within your text, it’s considered best to use Roman numerals for most citation styles. However, the most important thing here is to remain consistent whenever using numbers in your dissertation .

In most styles, the title page is used purely to provide information and doesn’t include any images. Ask your supervisor if you are allowed to include an image on the title page before doing so. If you do decide to include one, make sure to check whether you need permission from the creator of the image.

Include a note directly beneath the image acknowledging where it comes from, beginning with the word “ Note .” (italicized and followed by a period). Include a citation and copyright attribution . Don’t title, number, or label the image as a figure , since it doesn’t appear in your main text.

Definitional terms often fall into the category of common knowledge , meaning that they don’t necessarily have to be cited. This guidance can apply to your thesis or dissertation glossary as well.

However, if you’d prefer to cite your sources , you can follow guidance for citing dictionary entries in MLA or APA style for your glossary.

A glossary is a collection of words pertaining to a specific topic. In your thesis or dissertation, it’s a list of all terms you used that may not immediately be obvious to your reader. In contrast, an index is a list of the contents of your work organized by page number.

The title page of your thesis or dissertation goes first, before all other content or lists that you may choose to include.

The title page of your thesis or dissertation should include your name, department, institution, degree program, and submission date.

Glossaries are not mandatory, but if you use a lot of technical or field-specific terms, it may improve readability to add one to your thesis or dissertation. Your educational institution may also require them, so be sure to check their specific guidelines.

A glossary or “glossary of terms” is a collection of words pertaining to a specific topic. In your thesis or dissertation, it’s a list of all terms you used that may not immediately be obvious to your reader. Your glossary only needs to include terms that your reader may not be familiar with, and is intended to enhance their understanding of your work.

A glossary is a collection of words pertaining to a specific topic. In your thesis or dissertation, it’s a list of all terms you used that may not immediately be obvious to your reader. In contrast, dictionaries are more general collections of words.

An abbreviation is a shortened version of an existing word, such as Dr. for Doctor. In contrast, an acronym uses the first letter of each word to create a wholly new word, such as UNESCO (an acronym for the United Nations Educational, Scientific and Cultural Organization).

As a rule of thumb, write the explanation in full the first time you use an acronym or abbreviation. You can then proceed with the shortened version. However, if the abbreviation is very common (like PC, USA, or DNA), then you can use the abbreviated version from the get-go.

Be sure to add each abbreviation in your list of abbreviations !

If you only used a few abbreviations in your thesis or dissertation , you don’t necessarily need to include a list of abbreviations .

If your abbreviations are numerous, or if you think they won’t be known to your audience, it’s never a bad idea to add one. They can also improve readability, minimizing confusion about abbreviations unfamiliar to your reader.

A list of abbreviations is a list of all the abbreviations that you used in your thesis or dissertation. It should appear at the beginning of your document, with items in alphabetical order, just after your table of contents .

Your list of tables and figures should go directly after your table of contents in your thesis or dissertation.

Lists of figures and tables are often not required, and aren’t particularly common. They specifically aren’t required for APA-Style, though you should be careful to follow their other guidelines for figures and tables .

If you have many figures and tables in your thesis or dissertation, include one may help you stay organized. Your educational institution may require them, so be sure to check their guidelines.

A list of figures and tables compiles all of the figures and tables that you used in your thesis or dissertation and displays them with the page number where they can be found.

The table of contents in a thesis or dissertation always goes between your abstract and your introduction .

You may acknowledge God in your dissertation acknowledgements , but be sure to follow academic convention by also thanking the members of academia, as well as family, colleagues, and friends who helped you.

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

In a thesis or dissertation, the discussion is an in-depth exploration of the results, going into detail about the meaning of your findings and citing relevant sources to put them in context.

The conclusion is more shorter and more general: it concisely answers your main research question and makes recommendations based on your overall findings.

In the discussion , you explore the meaning and relevance of your research results , explaining how they fit with existing research and theory. Discuss:

• Your  interpretations : what do the results tell us?
• The  implications : why do the results matter?
• The  limitation s : what can’t the results tell us?

Results are usually written in the past tense , because they are describing the outcome of completed actions.

The results chapter of a thesis or dissertation presents your research results concisely and objectively.

In quantitative research , for each question or hypothesis , state:

• The type of analysis used
• Relevant results in the form of descriptive and inferential statistics
• Whether or not the alternative hypothesis was supported

In qualitative research , for each question or theme, describe:

• Recurring patterns
• Significant or representative individual responses
• Relevant quotations from the data

Don’t interpret or speculate in the results chapter.

To automatically insert a table of contents in Microsoft Word, follow these steps:

• Apply heading styles throughout the document.
• In the references section in the ribbon, locate the Table of Contents group.
• Click the arrow next to the Table of Contents icon and select Custom Table of Contents.
• Select which levels of headings you would like to include in the table of contents.

Make sure to update your table of contents if you move text or change headings. To update, simply right click and select Update Field.

All level 1 and 2 headings should be included in your table of contents . That means the titles of your chapters and the main sections within them.

The contents should also include all appendices and the lists of tables and figures, if applicable, as well as your reference list .

Do not include the acknowledgements or abstract in the table of contents.

The abstract appears on its own page in the thesis or dissertation , after the title page and acknowledgements but before the table of contents .

An abstract for a thesis or dissertation is usually around 200–300 words. There’s often a strict word limit, so make sure to check your university’s requirements.

In a thesis or dissertation, the acknowledgements should usually be no longer than one page. There is no minimum length.

The acknowledgements are generally included at the very beginning of your thesis , directly after the title page and before the abstract .

Yes, it’s important to thank your supervisor(s) in the acknowledgements section of your thesis or dissertation .

Even if you feel your supervisor did not contribute greatly to the final product, you must acknowledge them, if only for a very brief thank you. If you do not include your supervisor, it may be seen as a snub.

In the acknowledgements of your thesis or dissertation, you should first thank those who helped you academically or professionally, such as your supervisor, funders, and other academics.

Then you can include personal thanks to friends, family members, or anyone else who supported you during the process.

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Research Paper Guide

Research Paper Discussion Section

How To Write A Discussion For A Research Paper | Examples & Tips

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Ever find yourself stuck when trying to write the discussion part of your research paper? Don't worry, it happens to a lot of people. 

The discussion section is super important in your research paper . It's where you explain what your results mean. But turning all that data into a clear and meaningful story? That's not easy.

Guess what? MyPerfectWords.com has come up with a solution. 

This blog is your guide to writing an outstanding discussion section. We'll guide you step by step with useful tips to make sure your research stands out.

So, let’s get started!

• 1. What Exactly is a Discussion Section in the Research Paper?
• 2. How to Write the Discussion Section of a Research Paper?
• 3. Examples of Good Discussion for a Research Paper
• 4. Mistakes to Avoid in Your Research Paper's Discussion 

What Exactly is a Discussion Section in the Research Paper?

In a research paper, the discussion section is where you explain what your results really mean. It's like answering the questions, "So what?" and "What's the big picture?" 

The discussion section is your chance to help your readers understand why your findings are important and how they fit into the larger context. It's more than just summarizing; it's about making your research understandable and meaningful to others.

Importance of the Discussion Section

The discussion section isn't just a formality; it's the heart of your research paper. This is where your findings transform from data into knowledge. 

Let's break down why it's so crucial:

• Interpretation of Results : The discussion is where you get to tell readers what your results really mean. You go into the details, helping them understand the story behind the numbers or findings.
• Connecting the Dots : You connect different parts of your research, showing how they relate. This helps your readers see the bigger picture.
• Relevance to the Big Picture : You get to highlight why your research matters. How does it contribute to the broader understanding of the topic? This is your time to make your research significant.
• Addressing Limitations : In the discussion, you can acknowledge any limitations in your study and discuss how they might impact your results.
• Suggestions for Further Research : The discussion is where you suggest areas for future exploration. It's like passing the baton to the next researcher, indicating where more work could be done.

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How to Write the Discussion Section of a Research Paper?

The Discussion section in a research paper plays a vital role in interpreting findings and formulating a conclusion . Given below are the main components of the discussion section:

• Quick Summary: A brief recap of your main findings.
• Interpretation: Significance and meaning of your results in relation to your research question.
• Literature Review : Connecting your findings with previous research or similar studies.
• Limitations: Discussing any study limitations, addressing potential concerns.
• Implications: Broader implications of your findings, considering practical and theoretical aspects.
• Alternative Explanations: Evaluating alternative interpretations, demonstrating a comprehensive analysis.
• Connecting to Hypotheses : Summarizing how your result section aligns or diverges from your initial hypotheses.

Now let’s explore the steps to write an effective discussion section that will effectively communicate the significance of your research:

Step 1: Get Started with a Quick Summary

Start by quickly telling your readers the main things you found in your research. Don't explain them in detail just yet; just give a simple overview. 

This helps your readers get the big picture before diving into the details.

Step 2: Interpret Your Results

In the next step, talk about what your findings really mean. Share why the information you gathered is important. Connect each result to the questions you were trying to answer and the goals you set for your research.

Step 3: Relate to Existing Literature

In this step, link up your discoveries with what other researchers have already figured out. 

Share if your results are similar to or different from what's been found before. This helps give more background to your study and shows you know what other scientists have been up to.

Step 4: Address Limitations Honestly

Every study has its limitations. Acknowledge them openly in your discussion. This not only shows transparency but also helps readers interpret your results more accurately.

Step 5: Discuss the Implications

Explore the implications of your findings. How do they contribute to the field? What real-world applications or changes might they suggest?

Dig into why your discoveries are important. How do they help the subject you studied? 

This step is like looking at the bigger picture and asking, "So, what can we do with this information?"

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Step 6: Consider Alternative Explanations

After discussing the implications, challenge yourself by exploring alternative explanations for your results. 

Discuss different perspectives and show that you've considered multiple angles.

Step 7: Connect to Your Hypotheses or Research Questions

For the last step, revisit your initial hypotheses or research questions. Explain whether your results support what you thought might happen or if they surprised you. 

Examples of Good Discussion for a Research Paper

Learning from well-crafted discussions can significantly enhance your own writing. Given below are some examples to help you understand how to write your own.

Discussion for a Research Paper Example Pdf

Discussion for a Medical Research Paper

Discussion Section for a Qualitative Research Paper

Mistakes to Avoid in Your Research Paper's Discussion 

Writing the discussion section of your research paper can be tricky. To make sure you're on the right track, be mindful of these common mistakes:

• Overstating or Overinterpreting Results

Avoid making your findings sound more groundbreaking than they are. Stick to what your data actually shows, and don't exaggerate.

• Neglecting Alternative Explanations 

Failing to consider other possible explanations for your results can weaken your discussion. Always explore alternative perspectives to present a well-rounded view.

• Ignoring Limitations 

Don't sweep limitations under the rug. Acknowledge them openly and discuss how they might affect the validity or generalizability of your results.

• Being Overly Technical or Jargon-laden

Remember that your audience may not be experts in your specific field. Avoid using overly technical language or excessive jargon that could alienate your readers.

• Disregarding the 'So What' Factor

Always explain the significance of your findings. Don't leave your readers wondering why your research matters or how it contributes to the broader understanding of the subject.

• Rushing the Conclusion

The conclusion section of your discussion is critical. Don't rush it. Summarize the key points and leave your readers with a strong understanding of the significance of your research.

So, there you have it —writing a discussion and conclusion section isn't easy, but avoiding some common mistakes can make it much smoother. 

Remember to keep it real with your results, think about what else could explain things, and don't forget about any limits in your study.

But if you're feeling stuck, MyPerfectWords.com is here for you. 

Our team of experts knows their way around discussions. Whether you need some guidance or want someone to handle the writing for you, we've got your back.

Don't let discussion writing stress you out. Check out how the best essay writing service can make your academic life easier.

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Dr. Barbara is a highly experienced writer and author who holds a Ph.D. degree in public health from an Ivy League school. She has worked in the medical field for many years, conducting extensive research on various health topics. Her writing has been featured in several top-tier publications.

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07 Easy Steps for Writing Discussion Section of a Research Paper

Introduction

I. focus on the relevance.

• II. Highlight  the Limitations 
• III. Introduce  New Discoveries

IV. Highlight the Observations

V. compare and relate with other research works.

• VI. Provide  Alternate View Points

A. Future Directions

B. conclusion, how to validate the claims i made in the discussion section of my research paper, phrases that can be used in the discussion section of a research paper, phrases that can be used in the analysis part of the discussion section of a research paper.

• Your Next Move...

Whether charts and graphs are allowed in discussion section of my Research Paper?

Can i add citations in discussion section of my research paper, can i combine results and discussion section in my research paper, what is the weightage of discussion section in a research paper in terms of selection to a journal, whether literature survey paper has a discussion section.

The Discussion section of a research paper is where authors interpret their findings, contextualize their research, and propose future directions. It is a crucial section that provides the reader with insights into the significance and implications of the study.

Writing an effective discussion section is a crucial aspect of any research paper, as it allows researchers to delve into the significance of their findings and explore their implications. A well-crafted discussion section not only summarizes the key observations and limitations of the study but also establishes connections with existing research and opens avenues for future exploration. In this article, we will present a comprehensive guide to help you structure your discussion section in seven simple steps.

By following these steps, you’ll be able to write a compelling Discussion section that enhances the reader’s understanding of your research and contributes to the broader scientific community.

Please note, the discussion section usually follows after the Results Section. I have written a comprehensive article on ” How to Write Results Section of your Research Paper “. Please visit the article to enhance your write-up on the results section.

Which are these 07 steps for writing an Effective Discussion Section of a Research Paper?

Step 1: Focus on the Relevance : In the first step, we will discuss the importance of emphasizing the relevance of your research findings to the broader scientific context. By clearly articulating the significance of your study, you can help readers understand how your work contributes to the existing body of knowledge and why it matters.

Step 2: Highlight the Limitations : Every research study has its limitations, and it is essential to address them honestly and transparently. We will explore how to identify and describe the limitations of your study, demonstrating a thorough understanding of potential weaknesses and areas for improvement.

Step 3: Highlight the Observations : In this step, we will delve into the core findings of your study. We will discuss the key observations and results, focusing on their relevance to your research objectives. By providing a concise summary of your findings, you can guide readers through the main outcomes of your study.

Step 4: Compare and Relate with Other Research Works : Research is a collaborative and cumulative process, and it is vital to establish connections between your study and previous research. We will explore strategies to compare and relate your findings to existing literature, highlighting similarities, differences, and gaps in knowledge.

Step 5: Provide Alternate Viewpoints: Science thrives on the diversity of perspectives. Acknowledging different viewpoints and interpretations of your results fosters a more comprehensive understanding of the research topic. We will discuss how to incorporate alternative viewpoints into your discussion, encouraging a balanced and nuanced analysis.

Step 6: Show Future Directions : A well-crafted discussion section not only summarizes the present but also points towards the future. We will explore techniques to suggest future research directions based on the implications of your study, providing a roadmap for further investigations in the field.

Step 7: Concluding Thoughts : In the final step, we will wrap up the discussion section by summarizing the key points and emphasizing the overall implications of your research. We will discuss the significance of your study’s contributions and offer some closing thoughts to leave a lasting impression on your readers.

By following these seven steps, you can craft a comprehensive and insightful discussion section that not only synthesizes your findings but also engages readers in a thought-provoking dialogue about the broader implications and future directions of your research. Let’s delve into each step in detail to enhance the quality and impact of your discussion section.

The purpose of every research is to implement the results for the positive development of the relevant subject. In research, it is crucial to emphasize the relevance of your study to the field and its potential impact. Before delving into the details of how the research was conceived and the sequence of developments that took place, consider highlighting the following factors to establish the relevance of your work:

• Identifying a pressing problem or research gap: Example: “This research addresses the critical problem of network security in wireless communication systems. With the widespread adoption of wireless networks, the vulnerability to security threats has increased significantly. Existing security mechanisms have limitations in effectively mitigating these threats. Therefore, there is a pressing need to develop novel approaches that enhance the security of wireless communication systems.”
• Explaining the significance and potential impact of the research: Example: “By developing an intelligent intrusion detection system using machine learning algorithms, this research aims to significantly enhance the security of wireless networks. The successful implementation of such a system would not only protect sensitive data and communication but also ensure the reliability and integrity of wireless networks in various applications, including Internet of Things (IoT), smart cities, and critical infrastructure.”
• Establishing connections with previous research and advancements in the field: Example: “This study builds upon previous research on intrusion detection systems and machine learning techniques. By leveraging recent advancements in deep learning algorithms and anomaly detection methods, we aim to overcome the limitations of traditional rule-based intrusion detection systems and achieve higher detection accuracy and efficiency.”

By emphasizing the relevance of your research and articulating its potential impact, you set the stage for readers to understand the significance of your work in the broader context. This approach ensures that readers grasp the motivations behind your research and the need for further exploration in the field.

II. Highlight  the Limitations 

Many times the research is on a subject that might have legal limitations or restrictions. This limitation might have caused certain imperfections in carrying out research or in results. This issue should be acknowledged by the researcher before the work is criticized by others later in his/her discussion section.

In computer science research, it is important to identify and openly acknowledge the limitations of your study. By doing so, you demonstrate transparency and a thorough understanding of potential weaknesses, allowing readers to interpret the findings in a more informed manner. Here’s an example:

Example: “It is crucial to acknowledge certain limitations and constraints that have affected the outcomes of this research. In the context of privacy-sensitive applications such as facial recognition systems, there are legal limitations and ethical concerns that can impact the accuracy and performance of the developed algorithm. These limitations stem from regulations and policies that impose restrictions on data collection, access, and usage to protect individuals’ privacy rights. As a result, the algorithm developed in this study operates under these legal constraints, which may have introduced certain imperfections.”

In this example, the researcher is working on a facial recognition system and acknowledges the legal limitations and ethical concerns associated with privacy-sensitive applications. By openly addressing these limitations, the researcher demonstrates an understanding of the challenges imposed by regulations and policies. This acknowledgement sets the stage for a more nuanced discussion and prevents others from solely criticizing the work based on these limitations without considering the broader legal context.

By highlighting the limitations, researchers can also offer potential solutions or future directions to mitigate the impact of these constraints. For instance, the researcher may suggest exploring advanced privacy-preserving techniques or collaborating with legal experts to find a balance between privacy protection and system performance.

By acknowledging and addressing the limitations, researchers demonstrate their awareness of potential weaknesses in their study, maintaining credibility, and fostering a more constructive discussion of their findings within the context of legal and ethical considerations.

III. Introduce  New Discoveries

Begin the discussion section by stating all the major findings in the course of the research. The first paragraph should have the findings mentioned, which is expected to be synoptic, naming and briefly describing the analysis of results.

Example: “In this study, several significant discoveries emerged from the analysis of the collected data. The findings revealed compelling insights into the performance of parallel computing architectures for large-scale data processing. Through comprehensive experimentation and analysis, the following key discoveries were made:

• Discovery 1: The proposed parallel computing architecture demonstrated a 30% improvement in processing speed compared to traditional sequential computing methods. This finding highlights the potential of parallel computing for accelerating data-intensive tasks.
• Discovery 2: A direct relationship between the number of processing cores and the overall system throughput was observed. As the number of cores increased, the system exhibited a near-linear scalability, enabling efficient utilization of available computational resources.
• Discovery 3: The analysis revealed a trade-off between processing speed and energy consumption. While parallel computing achieved faster processing times, it also resulted in higher energy consumption. This finding emphasizes the importance of optimizing energy efficiency in parallel computing systems.

These discoveries shed light on the performance characteristics and trade-offs associated with parallel computing architectures for large-scale data processing tasks. The following sections will delve into the implications of these findings, discussing their significance, limitations, and potential applications.”

In this example, the researcher presents a concise overview of the major discoveries made during the research. Each discovery is briefly described, highlighting the key insights obtained from the analysis. By summarizing the findings in a synoptic manner, the reader gains an immediate understanding of the notable contributions and can anticipate the subsequent detailed discussion.

This approach allows the discussion section to begin with a clear and impactful introduction of the major discoveries, capturing the reader’s interest and setting the stage for a comprehensive exploration of each finding in subsequent paragraphs.

Coming to the major part of the findings, the discussion section should interpret the key observations, the analysis of charts, and the analysis of tables. In the field of computer science, presenting and explaining the results in a clear and accessible manner is essential for readers to grasp the significance of the findings. Here are some examples of how to effectively highlight observations in computer science research:

Begin with explaining the objective of the research, followed by what inspired you as a researcher to study the subject:

In a study on machine learning algorithms for sentiment analysis, start by stating the goal of developing an accurate and efficient sentiment analysis model. Share your motivation for choosing this research topic, such as the increasing importance of sentiment analysis in various domains like social media, customer feedback analysis, and market research.

Example: The objective of this research was to develop a sentiment analysis model using machine learning algorithms. As sentiment analysis plays a vital role in understanding public opinion and customer feedback, we were motivated by the need for an accurate and efficient model that could be applied in various domains such as social media analysis, customer reviews, and market research.

Explain the meaning of the findings, as every reader might not understand the analysis of graphs and charts as easily as people who are in the same field as you:

If your research involves analyzing performance metrics of different algorithms, consider presenting the results in a visually intuitive manner, such as line graphs or bar charts. In the discussion section, explain the significance of the trends observed in the graphs. For instance, if a particular algorithm consistently outperforms others in terms of accuracy, explain why this finding is noteworthy and how it aligns with existing knowledge in the field.

Example: To present the performance evaluation of the algorithms, we analyzed multiple metrics, including precision, recall, and F1 score. The line graph in Figure 1 demonstrates the trends observed. It is noteworthy that Algorithm A consistently outperformed the other algorithms across all metrics. This finding indicates that Algorithm A has a higher ability to accurately classify sentiment in comparison to its counterparts. This aligns with previous studies that have also highlighted the robustness of Algorithm A in sentiment analysis tasks.

Ensure the reader can understand the key observations without being forced to go through the whole paper:

In computer science research, it is crucial to present concise summaries of your key observations to facilitate understanding for readers who may not have the time or expertise to go through the entire paper. For example, if your study compares the runtime performance of two programming languages for a specific task, clearly state the observed differences and their implications. Highlight any unexpected or notable findings that may challenge conventional wisdom or open up new avenues for future exploration.

Example: In this study comparing the runtime performance of Python and Java for a specific computational task, we observed notable differences. Python consistently showed faster execution times, averaging 20% less time than Java across varying input sizes. These results challenge the common perception that Java is the superior choice for computationally intensive tasks. The observed performance advantage of Python in this context suggests the need for further investigation into the underlying factors contributing to this discrepancy, such as differences in language design and optimization strategies.

By employing these strategies, researchers can effectively highlight their observations in the discussion section. This enables readers to gain a clear understanding of the significance of the findings and their implications without having to delve into complex technical details.

No one is ever the only person researching a particular subject. A researcher always has companions and competitors. The discussion section should have a detailed comparison of the research. It should present the facts that relate the research to studies done on the same subject.

Example: The table below compares some of the well-known prediction techniques with our fuzzy predictor with MOM defuzzification for response time, relative error and Environmental constraints. Based on the results obtained it can be concluded that the Fuzzy predictor with MOM defuzzification has a less relative error and quick response time as compared to other prediction techniques.  The proposed predictor is more flexible, simple to implement and deals with noisy and uncertain data from real-life situations. The relative error of 5-10% is acceptable for our system as the predicted fuzzy region and the fuzzy region of the actual position remains the same.

Table 1 : Comparison of well-known Robot Motion prediction Techniques

VI. Provide  Alternate View Points

Almost every time, it has been noticed that analysis of charts and graphs shows results that tend to have more than one explanation. The researcher must consider every possible explanation and potential enhancement of the study from alternative viewpoints. It is critically important that this is clearly put out to the readers in the discussion section.

In the discussion section of a research paper, it is important to acknowledge that data analysis often yields results that can be interpreted in multiple ways. By considering different viewpoints and potential enhancements, researchers can provide a more comprehensive and nuanced analysis of their findings. Here are some examples:

Example 1: “The analysis of our experimental data showed a decrease in system performance following the implementation of the proposed optimization technique. While our initial interpretation suggested that the optimization failed to achieve the desired outcome, an alternate viewpoint could be that the decrease in performance was influenced by an external factor, such as the configuration of the hardware setup. Further investigation into the hardware settings and benchmarking protocols is necessary to fully understand the observed results and identify potential enhancements.”

Example 2: “The analysis of user feedback revealed a mixed response to the redesigned user interface. While some participants reported improved usability and satisfaction, others expressed confusion and dissatisfaction. An alternate viewpoint could be that the diverse range of user backgrounds and preferences might have influenced these varied responses. Further research should focus on conducting user studies with a larger and more diverse sample to gain a deeper understanding of the underlying factors contributing to the contrasting user experiences.”

Example 3: “Our study found a positive correlation between the implementation of agile methodologies and project success rates. However, an alternate viewpoint suggests that other factors, such as team dynamics and project complexity, could have influenced the observed correlation. Future research should explore the interactions between agile methodologies and these potential confounding factors to gain a more comprehensive understanding of their impact on project success.”

In these examples, researchers present alternative viewpoints that offer different interpretations or explanations for the observed results. By acknowledging these alternate viewpoints, researchers demonstrate a balanced and comprehensive analysis of their findings. It is crucial to clearly communicate these alternative perspectives to readers in the discussion section, as it encourages critical thinking and highlights the complexity and potential limitations of the research.

By presenting alternate viewpoints, researchers invite further exploration and discussion, fostering a more comprehensive understanding of the research topic. This approach enriches the scientific discourse and promotes a deeper analysis of the findings, contributing to the overall advancement of knowledge in the field.

VII. Future Directions and Conclusion

The section must have suggestions for research that should be done to unanswered questions. These should be suggested at the beginning of the discussion section to avoid questions being asked by critics. Emphasizing the importance of following future directions can lead to new research as well.

Example: ” While this study provides valuable insights into the performance of the proposed algorithm, there are several unanswered questions and avenues for future research that merit attention. By identifying these areas, we aim to stimulate further exploration and contribute to the continuous advancement of the field. The following future directions are suggested:

• Future Direction 1: Investigating the algorithm’s performance under different dataset characteristics and distributions. The current study focused on a specific dataset, but it would be valuable to evaluate the algorithm’s robustness and generalizability across a broader range of datasets, including real-world scenarios and diverse data sources.
• Future Direction 2: Exploring the potential integration of additional machine learning techniques or ensemble methods to further enhance the algorithm’s accuracy and reliability. By combining the strengths of multiple models, it is possible to achieve better performance and handle complex patterns and outliers more effectively.
• Future Direction 3: Extending the evaluation to consider the algorithm’s scalability in large-scale deployment scenarios. As the volume of data continues to grow exponentially, it is crucial to assess the algorithm’s efficiency and scalability in handling big data processing requirements.

By suggesting these future directions, we hope to inspire researchers to explore new avenues and build upon the foundation laid by this study. Addressing these unanswered questions will contribute to a more comprehensive understanding of the algorithm’s capabilities and limitations, paving the way for further advancements in the field.”

In this example, the researcher presents specific future directions that can guide further research. Each future direction is described concisely, highlighting the specific area of investigation and the potential benefits of pursuing those directions. By suggesting these future directions early in the discussion section, the researcher proactively addresses potential questions or criticisms and demonstrates a proactive approach to knowledge expansion.

By emphasizing the importance of following future directions, researchers not only inspire others to continue the research trajectory but also contribute to the collective growth of the field. This approach encourages ongoing exploration, innovation, and collaboration, ensuring the continuous development and improvement of computer science research.

In the final step, wrap up the discussion section by summarizing the key points and emphasizing the overall implications of your research. We will discuss the significance of your study’s contributions and offer some closing thoughts to leave a lasting impression on your readers. This section serves as a crucial opportunity to reinforce the main findings and highlight the broader impact of your work. Here are some examples:

Example 1: “In conclusion, this research has made significant contributions to the field of natural language processing. By proposing a novel neural network architecture for language generation, we have demonstrated the effectiveness and versatility of the model in generating coherent and contextually relevant sentences. The experimental results indicate a significant improvement in language generation quality compared to existing approaches. The implications of this research extend beyond traditional applications, opening up new possibilities for automated content creation, chatbot systems, and dialogue generation in artificial intelligence.”

Example 2: “In summary, this study has provided valuable insights into the optimization of network routing protocols for wireless sensor networks. By proposing a novel hybrid routing algorithm that combines the advantages of both reactive and proactive protocols, we have demonstrated enhanced network performance in terms of latency, energy efficiency, and scalability. The experimental results validate the effectiveness of the proposed algorithm in dynamic and resource-constrained environments. These findings have implications for various applications, including environmental monitoring, industrial automation, and smart city infrastructure.”

Example 3: “In closing, this research sheds light on the security vulnerabilities of blockchain-based smart contracts. By conducting an extensive analysis of existing smart contract platforms and identifying potential attack vectors, we have highlighted the need for robust security measures to mitigate risks and protect user assets. The insights gained from this study can guide the development of more secure and reliable smart contract frameworks, ensuring the integrity and trustworthiness of blockchain-based applications across industries such as finance, supply chain, and decentralized applications.”

In these examples, the concluding thoughts summarize the main contributions and findings of the research. They emphasize the significance of the study’s implications and highlight the potential impact on various domains within computer science. By providing a succinct and impactful summary, the researcher leaves a lasting impression on readers, reinforcing the value and relevance of the research in the field.

Validating claims in the discussion section of a research paper is essential to ensure the credibility and reliability of your findings. Here are some strategies to validate the claims made in the discussion section:

• Referencing supporting evidence: Cite relevant sources from the existing literature that provide evidence or support for your claims. These sources can include peer-reviewed studies, research articles, and authoritative sources in your field. By referencing credible and reputable sources, you establish the validity of your claims and demonstrate that your interpretations are grounded in existing knowledge.
• Relating to the results: Connect your claims to the results presented in the earlier sections of your research paper. Clearly demonstrate how the findings support your claims and provide evidence for your interpretations. Refer to specific data, measurements, statistical analyses, or other evidence from your results section to substantiate your claims.
• Comparing with previous research: Discuss how your findings align with or diverge from previous research in the field. Reference relevant studies and explain how your results compare to or build upon existing knowledge. By contextualizing your claims within the broader research landscape, you provide further validation for your interpretations.
• Addressing limitations and alternative explanations: Acknowledge the limitations of your study and consider alternative explanations for your findings. By addressing potential counterarguments and alternative viewpoints, you demonstrate a thorough evaluation of your claims and increase the robustness of your conclusions.
• Seeking peer feedback: Prior to submitting your research paper, consider seeking feedback from colleagues or experts in your field. They can provide valuable insights and suggestions for further validating your claims or improving the clarity of your arguments.
• Inviting replication and further research: Encourage other researchers to replicate your study or conduct further investigations. By promoting replication and future research, you contribute to the ongoing validation and refinement of your claims.

Remember, the validation of claims in the discussion section is a critical aspect of scientific research. By employing rigorous methods and logical reasoning, you can strengthen the credibility and impact of your findings and contribute to the advancement of knowledge in your field.

Here are some common phrases that can be used in the discussion section of a paper or research article. I’ve included a table with examples to illustrate how these phrases might be used:

Here are some common academic phrases that can be used in the analysis section of a paper or research article. I have included a table with examples to illustrate how these phrases might be used:

Your Next Move…

I believe you will proceed to write conclusion section of your research paper. Conclusion section is the most neglected part of the research paper as many authors feel it is unnecessary but write in a hurry to submit the article to some reputed journal.

Please note, once your paper gets published , the readers decide to read your full paper based only on abstract and conclusion. They decide the relevance of the paper based on only these two sections. If they don’t read then they don’t cite and this in turn affects your citation score. So my sincere advice to you is not to neglect this section.

Visit my article on “How to Write Conclusion Section of Research Paper” for further details.

Please visit my article on “ Importance and Improving of Citation Score for Your Research Paper ” for increasing your visibility in research community and on Google Scholar Citation Score.

The Discussion section of a research paper is an essential part of any study, as it allows the author to interpret their results and contextualize their findings. To write an effective Discussion section, authors should focus on the relevance of their research, highlight the limitations, introduce new discoveries, highlight their observations, compare and relate their findings to other research works, provide alternate viewpoints, and show future directions.

By following these 7 steps, authors can ensure that their Discussion section is comprehensive, informative, and thought-provoking. A well-written Discussion section not only helps the author interpret their results but also provides insights into the implications and applications of their research.

In conclusion, the Discussion section is an integral part of any research paper, and by following these 7 steps, authors can write a compelling and informative discussion section that contributes to the broader scientific community.

Frequently Asked Questions

Yes, charts and graphs are generally allowed in the discussion section of a research paper. While the discussion section is primarily focused on interpreting and discussing the findings, incorporating visual aids such as charts and graphs can be helpful in presenting and supporting the analysis.

Yes, you can add citations in the discussion section of your research paper. In fact, it is highly recommended to support your statements, interpretations, and claims with relevant and credible sources. Citations in the discussion section help to strengthen the validity and reliability of your arguments and demonstrate that your findings are grounded in existing literature.

Combining the results and discussion sections in a research paper is a common practice in certain disciplines, particularly in shorter research papers or those with specific formatting requirements. This approach can help streamline the presentation of your findings and provide a more cohesive narrative. However, it is important to note that the decision to combine these sections should be based on the guidelines of the target journal or publication and the specific requirements of your field.

The weightage of the discussion section in terms of the selection of a research paper for publication in a journal can vary depending on the specific requirements and criteria of the journal. However, it is important to note that the discussion section is a critical component of a research paper as it allows researchers to interpret their findings, contextualize them within the existing literature, and discuss their implications.

In general, literature survey papers typically do not have a separate section explicitly labeled as “Discussion.” However, the content of a literature survey paper often incorporates elements of discussion throughout the paper. The focus of a literature survey paper is to review and summarize existing literature on a specific topic or research question, rather than presenting original research findings.

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The Process of Writing a Research Paper Guide: The Discussion

• Types of Research Designs
• Choosing a Research Topic
• Preparing to Write
• The Abstract
• The Introduction
• The Literature Review
• The Methodology
• The Results
• The Discussion
• The Conclusion
• Proofreading Your Paper
• Citing Sources
• Annotated Bibliography
• Giving an Oral Presentation
• How to Manage Group Projects
• Writing a Book Review
• Writing a Research Proposal
• Acknowledgements

The purpose of the discussion is to interpret and describe the significance of your findings in light of what was already known about the research problem being investigated and to explain any new understanding or insights that emerged as a result of your study of the problem. The discussion will always connect to the introduction by way of the research questions or hypotheses you posed and the literature you reviewed, but the discussion does not simply repeat or rearrange the first parts of your paper; the discussion clearly explain how your study advanced the reader's understanding of the research problem from where you left them at the end of your review of prior research.

Importance of a Good Discussion

The discussion section is often considered the most important part of your research paper because this is where you:

• Most effectively demonstrates your ability as a researcher to think critically about an issue, to develop creative solutions to problems based upon a logical synthesis of the findings, and  to formulate a deeper, more profound understanding of the research problem under investigation,
• Present the underlying meaning of your research, note possible implications in other areas of study, and explore possible improvements that can be made in order to further develop the concerns of your research,
• Highlight the importance of your study and how it may be able to contribute to and/or help fill existing gaps in the field. If appropriate, the discussion section is also where you state how the findings from your study revealed and helped fill gaps in the literature that had not been previously exposed or adequately described, and
• Engage the reader in thinking critically about issues based upon an evidence-based interpretation of findings; it is not governed strictly by objective reporting of information.

Annesley Thomas M. “The Discussion Section: Your Closing Argument.”  Clinical Chemistry  56 (November 2010): 1671-1674; Bitchener, John and Helen Basturkmen. “Perceptions of the Difficulties of Postgraduate L2 Thesis Students Writing the Discussion Section.”  Journal of English for Academic Purposes  5 (January 2006): 4-18; Kretchmer, Paul.  Fourteen Steps to Writing an Effective Discussion Section . San Francisco Edit, 2003-2008.

Structure and Writing Style

I.  General Rules

These are the general rules you should adopt when composing your discussion of the results :

• Do not be verbose or repetitive
• Be concise  and make your points clearly
• Avoid the use of jargon or undefined technical language
• Follow a logical stream of thought; in general, interpret and discuss the significance of your findings in the same sequence you described them in your results section [a notable exception is to begin by highlighting an unexpected result or finding]
• Use the present verb tense, especially for established facts; however, refer to specific works or prior studies in the past tense
• If needed, use subheadings to help organize your discussion or to categorize your interpretations into themes

II.  The Content

The content of the discussion section of your paper most often includes :

• Explanation of results : comment on whether or not the results were expected for each set of results; go into greater depth to explain findings that were unexpected or especially profound. If appropriate, note any unusual or unanticipated patterns or trends that emerged from your results and explain their meaning in relation to the research problem.
• References to previous research : either compare your results with the findings from other studies or use the studies to support a claim. This can include re-visiting key sources already cited in your literature review section, or, save them to cite later in the discussion section if they are more important to compare with your results instead of being a part of the general literature review of research used to provide context and background information. Note that you can make this decision to highlight specific studies after you have begun writing the discussion section.
• Deduction : a claim for how the results can be applied more generally. For example, describing lessons learned, proposing recommendations that can help improve a situation, or highlighting best practices.
• Hypothesis : a more general claim or possible conclusion arising from the results [which may be proved or disproved in subsequent research]. This can be framed as new research questions that emerged as a result of your analysis.

III.  Organization and Structure

Keep the following sequential points in mind as you organize and write the discussion section of your paper:

• Think of your discussion as an inverted pyramid. Organize the discussion from the general to the specific, linking your findings to the literature, then to theory, then to practice [if appropriate].
• Use the same key terms, narrative style, and verb tense [present] that you used when when describing the research problem in your introduction.
• Begin by briefly re-stating the research problem you were investigating and answer all of the research questions underpinning the problem that you posed in the introduction.
• Describe the patterns, principles, and relationships shown by each major findings and place them in proper perspective. The sequence of this information is important; first state the answer, then the relevant results, then cite the work of others. If appropriate, refer the reader to a figure or table to help enhance the interpretation of the data [either within the text or as an appendix].
• Regardless of where it's mentioned, a good discussion section includes analysis of any unexpected findings. This part of the discussion should begin with a description of the unanticipated finding, followed by a brief interpretation as to why you believe it appeared and, if necessary, its possible significance in relation to the overall study. If more than one unexpected finding emerged during the study, describe each of them in the order they appeared as you gathered or analyzed the data. As noted, the exception to discussing findings in the same order you described them in the results section would be to begin by highlighting the implications of a particularly unexpected or significant finding that emerged from the study, followed by a discussion of the remaining findings.
• Before concluding the discussion, identify potential  limitations and weaknesses  if you do not plan to do so in the conclusion of the paper. Comment on their relative importance in relation to your overall interpretation of the results and, if necessary, note how they may affect the validity of your findings. Avoid using an apologetic tone; however, be honest and self-critical [e.g., had you included a particular question in a survey instrument, additional data could have been revealed].
• The discussion section should end with a concise summary of the principal implications of the findings regardless of their significance. Give a brief explanation about why you believe the findings and conclusions of your study are important and how they support broader knowledge or understanding of the research problem. This can be followed by any recommendations for further research. However, do not offer recommendations which could have been easily addressed within the study. This would demonstrate to the reader that you have inadequately examined and interpreted the data.

IV.  Overall Objectives

The objectives of your discussion section should include the following: I.   Reiterate the Research Problem/State the Major Findings

Briefly reiterate the research problem or problems you are investigating and the methods you used to investigate them, then move quickly to describe the major findings of the study. You should write a direct, declarative, and succinct proclamation of the study results, usually in one paragraph.

II.   Explain the Meaning of the Findings and Why They are Important

Consider the likelihood that no one has thought as long and hard about your study as you have. Systematically explain the underlying meaning of your findings and state why you believe they are significant. After reading the discussion section, you want the reader to think critically about the results [“why didn't I think of that?”]. You don’t want to force the reader to go through the paper multiple times to figure out what it all means. If applicable, begin this part of the section by repeating what you consider to be your most significant or unanticipated finding first, then systematically review each finding. Otherwise, follow the general order you reported the findings in the results section.

III.   Relate the Findings to Similar Studies

No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your results to those found in other studies, particularly if questions raised from prior studies served as the motivation for your research. This is important because comparing and contrasting the findings of other studies helps to support the overall importance of your results and it highlights how and in what ways your study differs from other research about the topic. Note that any significant or unanticipated finding is often because there was no prior research to indicate the finding could occur. If there is prior research to indicate this, you need to explain why it was significant or unanticipated. IV.   Consider Alternative Explanations of the Findings

It is important to remember that the purpose of research in the social sciences is to  discover  and not to  prove . When writing the discussion section, you should carefully consider all possible explanations for the study results, rather than just those that fit your hypothesis or prior assumptions and biases. This is especially important when describing the discovery of significant or unanticipated findings.

V.   Acknowledge the Study’s Limitations

It is far better for you to identify and acknowledge your study’s limitations than to have them pointed out by your professor! Note any unanswered questions or issues your study did not address and describe the generalizability of your results to other situations. If a limitation is applicable to the method chosen to gather information, then describe in detail the problems you encountered and why. VI.   Make Suggestions for Further Research

You may choose to conclude the discussion section by making suggestions for further research [this can be done in the overall conclusion of your paper]. Although your study may offer important insights about the research problem, this is where you can address other questions related to the problem that remain unanswered or highlight previously hidden questions that were revealed as a result of conducting your research. You should frame your suggestions by linking the need for further research to the limitations of your study [e.g., in future studies, the survey instrument should include more questions that ask..."] or linking to critical issues revealed from the data that were not considered initially in your research.

NOTE:  Besides the literature review section, the preponderance of references to sources is usually found in the discussion section . A few historical references may be helpful for perspective, but most of the references should be relatively recent and included to aid in the interpretation of your results or used to link to similar studies. If a study that you cited does not support your findings, don't ignore it--clearly explain why your research findings differ from theirs.

V.  Problems to Avoid

• Do not waste time restating your results . Should you need to remind the reader of a finding to be discussed, use "bridge sentences" that relate the result to the interpretation. An example would be: “In the case of determining available housing to single women with children in rural areas of Texas, the findings suggest that access to good schools is important," then move on to further explaining this finding and its implications.
• Recommendations for further research can be included in either the discussion or conclusion of your paper,  but do not repeat your recommendations in the both sections. Think about the overall narrative flow of your paper to determine where best to locate this information. However, if your findings raise a lot of new questions or issues, consider including suggestions for further research in the discussion section.
• Do not introduce new results in the discussion section.  Be wary of mistaking the reiteration of a specific finding for an interpretation because it may confuse the reader. The description of findings [results] and the interpretation of their significance [discussion] should be distinct sections of your paper. If you choose to combine the results section and the discussion section into a single narrative, you must be clear in how you report the information discovered and your own interpretation of each finding. This approach is not recommended if you lack experience writing college-level research papers.
• Use of the first person pronoun is generally acceptable.  Using first person singular pronouns can help emphasize a point or illustrate a contrasting finding. However, keep in mind that too much use of the first person can actually distract the reader from the main points [i.e., I know you're telling me this; just tell me!].

Analyzing vs. Summarizing . Department of English Writing Guide. George Mason University;  Discussion . The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Hess, Dean R. "How to Write an Effective Discussion."  Respiratory Care  49 (October 2004); Kretchmer, Paul.  Fourteen Steps to Writing to Writing an Effective Discussion Section . San Francisco Edit, 2003-2008;  The Lab Report . University College Writing Centre. University of Toronto; Sauaia, A. et al. "The Anatomy of an Article: The Discussion Section: "How Does the Article I Read Today Change What I Will Recommend to my Patients Tomorrow?”  The Journal of Trauma and Acute Care Surgery  74 (June 2013): 1599-1602;  Research Limitations & Future Research . Lund Research Ltd., 2012;  Summary: Using it Wisely . The Writing Center. University of North Carolina; Schafer, Mickey S.  Writing the Discussion . Writing in Psychology course syllabus. University of Florida; Yellin, Linda L.  A Sociology Writer's Guide . Boston, MA: Allyn and Bacon, 2009.

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INFORMS Open Forum

Announcing the 2024 informs railway applications section student paper competition, 1.  announcing the 2024 informs railway applications section student paper competition.

The Railway Applications Section (RAS) of INFORMS eagerly awaits your submission for the 2024 Student Paper Competition. If your research delves into innovative analytics and fact-based decision-making in railway applications, then this competition, which offers three cash prizes totaling US$1,750, is the competition for you. Mark your calendar for the July 12, 2024, submission deadline.

Why You Should Participate:

• Spotlight Your Research: Share your insights and solutions with leading experts and peers in the railway industry.
• Network and Connect: Forge valuable connections with industry professionals, opening doors to future opportunities.
• Earn Recognition and Prizes: Stand out with your contributions and compete for a share of the $1,750 prize pool.

Eligibility Criteria : We welcome submissions from BSc, MSc, and Ph.D. students enrolled any time in 2024. Your research should present original work in operations research or management science with relevance to freight or passenger railway systems.

Present Your Work : Winners will have the privilege of presenting their research to an esteemed audience at the INFORMS Annual Meeting, October 20-23, 2024, in Seattle, Washington, USA.

For full competition rules and submission guidelines, visit Competition Guidelines .

Have Questions? Reach out to Dr. Erick Wikum ( [email protected] ) or Dr. Nikola Marković ( [email protected] ) . Please mention "2024 INFORMS RAS Student Paper Competition" in your email subject.

Important Dates:

• Submission Deadline: July 12, 2024
• Announcement of Winners: September 13, 2024
• INFORMS Meeting Presentation: October 20-23, 2024

Join RAS, the connection point for those applying Operations Research and Management Science in the railway sector and contribute to a tradition of innovation. Dive deeper into our mission and community at INFORMS RAS .

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Related content, [deadline approaching] ras student paper competition, ras problem solving competition - webinar #4, [extended deadline] ras problem solving competition, ras problem solving competition - webinar #3, ras problem solving competition - webinar #2.

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• Open access
• Published: 02 March 2023

Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review with implications for the function of the oxytocinergic system

• Sarah Buckley 1 ,
• Kerstin Uvnäs-Moberg 2 ,
• Zada Pajalic 3 ,
• Karolina Luegmair 4 ,
• Anette Ekström-Bergström 5 ,
• Anna Dencker 6 ,
• Claudia Massarotti 7 ,
• Alicja Kotlowska 8 ,
• Leonie Callaway 1 ,
• Sandra Morano 7 ,
• Ibone Olza 9 &
• Claudia Meier Magistretti 10  

BMC Pregnancy and Childbirth volume  23 , Article number:  137 ( 2023 ) Cite this article

12k Accesses

7 Citations

2 Altmetric

Metrics details

The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.

To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.

Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.

Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2–3 times physiological levels.

Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher.

Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.

Conclusions

Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2–3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.

Peer Review reports

Oxytocin is of critical importance for labour and birth through its stimulatory effects on uterine contractions [ 1 ]. Oxytocin is also involved in bonding, maternal caregiving, lactation and stress regulation, among other biological effects [ 2 ]. Synthetic oxytocin (Syntocinon, Pitocin, exogenous oxytocin) has an identical chemical structure to endogenous oxytocin and is widely administered to women to induce or augment labour, and to prevent or treat postpartum haemorrhage.

Endogenous oxytocin is produced by neurons within the supra-optic and paraventricular nuclei (SON and PVN) in the hypothalamus and transferred to the posterior pituitary gland for release into the circulation to the periphery. Peripheral physiological effects of endogenous oxytocin include facilitating the uterine contractions of labour and birth and the milk-ejection (‘let down’) reflex of lactation. In addition, oxytocin from the SON and PVN reaches and impacts widespread areas in the brain via oxytocinergic nerves and axon collaterals, and by dendritic release from the SON and PVN. In this way oxytocin can exert integrated psychophysiological effects [ 3 , 4 ].

Maternal oxytocin levels rise gradually during pregnancy in response to rising levels of estrogen. Estrogen also increases the numbers and function (binding) of uterine oxytocin receptors in preparation for labour, birth and postpartum transitions [ 1 ]. As labour commences, pulses of oxytocin are released from the pituitary. These pulses increase in frequency, duration and amplitude, reaching a maximal frequency of three pulses per ten minutes [ 5 ]. These oxytocin peaks are preceded by brief (milliseconds) periods of electrical activity in the oxytocin neurons in the hypothalamus [ 6 ].

Oxytocin is also produced within the uterine decidua and other local tissues, and there are oxytocin receptors within these tissues [ 7 , 8 ]. During labour, this paracrine oxytocin causes an increase in decidual prostaglandin production. Local prostaglandins contribute to myometrial contractions and likely cervical changes and may give local positive feedback to oxytocin pro-contractile effects [ 7 , 9 ]. Findings from transgenic animal studies suggest that other processes and pathways to parturition may exist outside of the classical oxytocin system, reflecting the critical role of parturition in mammalian survival [ 10 , 11 ].

The autonomic nervous system (ANS) also contributes to the control of uterine contractions and labour progress. The uterus is innervated by both branches of the ANS: the parasympathetic nervous system (PSNS) and the sympathetic nervous system (SNS).

Parasympathetic pathways involve oxytocin nerves that originate in oxytocin-producing areas of the PVN and reach the uterus via cholinergic neurons of the PSNS ganglia in the lumbosacral region [ 12 , 13 ]. Stimulation of outgoing (motor, efferent) PSNS nerve pathways from the brain causes uterine contractions and increases blood supply to the uterus [ 14 ]. In contrast, stimulation of SNS efferent nerves can cause long-lasting, painful and/or ineffective contractions and reduce uterine blood flow [ 14 ].

Labour processes are also controlled centrally by incoming (sensory, afferent) ANS nerves, which transmit information about the physiological state of the cervix, vagina and uterine muscles to regulatory centres in the brain. This sensory information helps to regulate oxytocin release during labour [ 15 ].

Oxytocin release is further promoted in labour by the Ferguson reflex, a positive feedback cycle that is stimulated by sensory input from the pressure of the baby’s head on the cervix, caused by uterine contractions [ 16 ]. This sensory input, transmitted by PSNS sensory nerves via spinal cord pathways, triggers the release of oxytocin from the posterior pituitary into the circulation [ 1 ]. Oxytocin release further strengthens uterine contractions, and therefore pressure from the fetal head on the cervix, fuelling this positive feed-back cycle [ 1 ].

Oxytocin levels during labour may also be influenced by local conditions in the uterine tissues. When the uterine muscles contract, local pressures temporarily occlude the blood supply, creating relatively low oxygen levels in the muscle. The resulting anaerobic metabolism produces lactic acid and increased acidity (lower pH), which inhibits intramuscular calcium channels, weakening or even stopping contractions. As the uterine contraction subsides, blood flow is restored, with increased oxygenation and removal of acid metabolites. These metabolic changes provide feedback inhibition for the current uterine contraction and subsequently prepare the uterine muscles for the next contraction. This model is illustrated in Fig.  1 and well described by Wray and Wiberg-Itzel [ 17 , 18 , 19 ].

Uterine contraction and relaxation: metabolic, autonomic and haemodynamic effects for mother, uterus, and fetus. Note: Equal lengths of contraction and relaxation are for illustration only. In labour the period of contraction is relatively shorter, with a relatively longer period of relaxation that allows full replenishment of blood supply to the uterus and fetus, as shown in the figure. As labour progresses, contractions become stronger and more frequent with relatively shorter periods of relaxation in between. Infusions of synthetic oxytocin cause stronger and more frequent contractions, which further shortens the relative time for replenishment in uterine tissues. This may increase maternal pain and stress and reduce fetal blood flow. In this way, administration of synthetic oxytocin may exaggerate maternal metabolic and autonomic consequences and fetal blood flow reductions induced by the contractions of physiological birth, as illustrated. Abbreviations: O 2: oxygen; pH: measure of acidity; PSNS: parasympathetic nervous system; SNS: sympathetic nervous system (Figure 1 copyright S Buckley and K Uvnäs-Moberg, 2023)

In addition, autonomic sensory nerves originating in the myometrium are involved in this metabolic feedback mechanism. During contractions, SNS nerves are activated in response to the local metabolic stresses and induce maternal pain and stress via central actions. In addition, as the ANS balance shifts towards the SNS, oxytocin release is decreased [ 15 ]. There may also be a functional decrease in oxytocin receptor function as part of this feedback inhibition, although this has not been studied.

As the contraction and the contraction-related metabolic stresses subside, signalling in the SNS decreases and the inhibition of oxytocin release is withdrawn. The balance in the ANS shifts from the SNS back towards the PSNS, with rising oxytocin levels further promoting the next uterine contraction [ 17 , 18 , 19 ]. (See Fig.  1 ). Oxytocin receptor function may also be reinstated. This model is also supported by the findings of variations in oxytocin levels during the contractions of physiological labour [ 20 ].

Oxytocin is elevated not only in the circulation but also within the maternal brain from labour to postpartum. Oxytocin elevations counteract stress, fear and pain, and induce positive feelings in birthing women [ 21 ]. Oxytocin also facilitates beneficial maternal adaptations, including the activation of brain reward centres that facilitate maternal-newborn bonding and caretaking [ 1 , 21 ] Oxytocin elevations in labour may also sensitise maternal skin, so that the new mother maximally releases oxytocin during skin-to-skin contact with her newborn, and promote the initiation of lactation [ 1 , 2 ].

The fetus also produces oxytocin, which is released during labour and birth into both the brain and circulation. Fetal oxytocin release may be promoted by skin stimulation from uterine contractions and also by the physiological stresses of labour [ 22 ]. Oxytocin provides beneficial analgesic, antioxidant and anti-inflammatory effects for the fetus and newborn [ 23 , 24 ].

Other physiological and hormonal processes also provide substantial protection for the fetus from contraction-related reductions in blood and oxygen during labour. The inevitable hypoxia of labour, along with increasing pressure on the fetal head, triggers the release of very high levels of adrenaline and noradrenaline. This ‘fetal catecholamine surge’ prioritises essential blood supply to the heart and brain and promotes anerobic glycolysis, among other fetal adaptations [ 25 , 26 , 27 , 28 ].

This model of oxytocin-associated metabolic and physiological effects with contractions is also valid for the effects of synthetic oxytocin on contractions. With synthetic oxytocin, contractions are stronger and also more frequent, which makes the relative duration of contractions vs. relaxation longer [ 29 , 30 , 31 ]. This exaggerates the maternal metabolic and autonomic and fetal haemodynamic effects caused by contractions, as described in Fig.  1 . Therefore, synthetic oxytocin may be linked to more negative consequences than physiological labour for mother and baby, especially when high infusion rates cause significantly stronger and more frequent contractions.

It is estimated that up to half of women giving birth in institutionalised maternity care systems, including in low- and middle-income countries, will receive synthetic oxytocin for labour induction or augmentation [ 32 , 33 , 34 ]. In addition, routine administration of synthetic oxytocin is recommended to prevent postpartum haemorrhage after vaginal birth, either by intramuscular injection or intravenous administration [ 35 , 36 ]. Synthetic oxytocin can also be administered by postpartum intravenous infusion to treat haemorrhage following vaginal birth or routinely after caesarean section.

With this widespread use of synthetic oxytocin in labour, birth and postpartum, it is important to review the data on oxytocin levels in connection with perinatal synthetic oxytocin administration for several reasons.

Data on maternal and newborn levels of oxytocin in response to administration of synthetic oxytocin are not readily available and there is no review summarising this data. A primary aim of this review was to summarise this data, making it understandable and accessible for clinicians and other researchers.

Another aim of this study was to illustrate that administration of synthetic oxytocin by intravenous infusion follows the expected pharmacological rules. Plasma oxytocin levels would be expected to rise in a dose-dependent way, have a well-defined half-life and achieve steady state levels after a defined period of time, analogous to what is observed after administration of other drugs. An available summary of this data might aid clinicians to ascertain the appropriate infusion rates of synthetic oxytocin during labour and postpartum and reduce the chances of adverse effects.

High infusion rates of synthetic oxytocin might result in supra-physiological oxytocin levels, which could have biological impacts for women and babies in labour. A further aim was therefore to provide data that might assist with assessing the likelihood of potential side-effects, short- or longer-term, for women administered synthetic oxytocin in the perinatal period and their offspring.

The aim of this study was to systematically review the existing literature on maternal and newborn plasma oxytocin levels following maternal synthetic oxytocin administration during labour, birth and/or postpartum and to consider possible implications for women and offspring.

A systematic literature search was undertaken according to the PRISMA statement with the aim of summarising existing research regarding the effect of maternal administration of synthetic oxytocin on maternal and newborn plasma oxytocin levels [ 37 ].

Selection of studies and eligibility

An a priori protocol was designed with the aim, procedure and inclusion criteria. We included studies of women in labour, birth and/or postpartum and their newborns (participants) who were exposed to maternal administration of synthetic oxytocin (intervention) and who had at least one post-intervention measurement of plasma oxytocin levels (outcome), allowing comparison with pre-intervention levels or with controls who did not receive synthetic oxytocin, where such data was available (comparison).

All types of peer-reviewed articles reporting original research written in any language understood by the research team (English, German, Spanish, French, Swedish) were considered, with any date of publication up to June 14, 2022. In addition, findings were included from one Swedish PhD thesis that included a rigorous peer review as part of the examination process, and from several publications in Japanese, including one with unique data that was professionally translated. Inclusion criteria are listed in Table  1 .

We included only studies that measured plasma oxytocin levels and not salivary or urine oxytocin levels, as such measurements have not been shown to accurately mirror plasma oxytocin levels or physiological patterns [ 38 , 39 , 40 , 41 ].

Search strategy and screening

The search strings were created by SB and AEB, together with librarians from the University of Queensland, Australia, and the University of Skövde, Sweden. Searches were performed in September 2017 in the following databases: PubMed, Scopus, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and PsycInfo. Additional literature searches using the same search strings were completed in March 2020 and June 2022. The search terms comprise synonyms and database-specific terms for oxytocin AND levels AND blood/plasma AND labour/birth/breastfeeding/interventions/newborns. The full search strings are available in Additional file 1.

In total, 3847 articles were identified via database searches (PubMed n  = 1598, Scopus n  = 1769, CINAHL n  = 247, and PsycInfo n  = 233). The reference lists of all eligible publications were also hand searched and eight additional articles were found (total 3855). After the removal of 613 duplicates, the remaining 3242 articles were screened on title and abstract and 2914 were excluded. After the full-text screening of the remaining 328 articles, 35 articles were identified that met the inclusion criteria. These 35 publications are based on 31 clinical studies, as four publications reported findings from other included studies.

At each stage, articles were screened by at least two authors, working independently in pairs, based on the inclusion and exclusion criteria (Table  1 ). Initial title and abstract screening were performed using the Covidence© online platform by AEB, CM, GDB, KL, KUM, SB and ZP. In case inclusion was unclear, a third expert author (KUM) was involved. Subsequent screening, hand searches, full-text review, final inclusion, and data extraction were done by SB and KUM. The selection process is illustrated in Fig.  2 , based on the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol, including reasons for exclusion at full-text screening [ 37 ].

Selection process (Prisma)

Data extraction and analysis

Altogether, 1373 women and 148 newborns participated in studies reported in the 35 publications summarised in this paper. The included publications are listed in Table  2 , ‘Characteristics of included studies,’ together with background data including the type of interventions and the numbers of participants, including women and newborns without exposure to synthetic oxytocin (controls).

It was not possible to perform a meta-analysis because the study designs varied substantially in relation to indications for administration of oxytocin; dose regimens and timing; presence of a control group; timing, frequency and techniques of blood sampling; assay types and assay sensitivities. We therefore extracted data from each publication. Text summaries were formulated, and the extracted data was also summarised in separate tables for maternal and newborn oxytocin levels (Tables  3 and 4 respectively.)

Quality assessment considerations

We ensured that the quality of the data was as high as possible through strict inclusion criteria. We carefully subdivided the data into groups of similar study designs. We also paid close attention to techniques and methodologies that might influence the results, including types of assays and assay sensitivities. The strengths and limitations of each study are further discussed in the tables and text.

It is noteworthy that many of the included studies were published more than 20 years ago. However, most of these older studies are of very high quality and assess plasma oxytocin levels with frequent and multiple sampling and high-quality assays, giving comprehensive and reliable data. In contrast, some of the more recent studies were limited by technical, practical, and other considerations, and generally included fewer samples.

Endogenous and synthetic oxytocin are biochemically identical and therefore the same techniques can be used to measure both synthetic and endogenous oxytocin in plasma.

An important quality assessment consideration is the type of assay used to measure plasma oxytocin levels. Radioimmunoassay (RIA) is the gold standard but is expensive and requires radioactive material. More recent studies have more often used Enzyme-Linked Immunosorbent Assay/Immunoassay (ELISA, EIA). Oxytocin levels and effect patterns measured with ELISA can differ from those obtained by RIA, with values up to 10–100 fold higher, especially without sample extraction prior to analysis. In addition, ELISA is less specific, as the high levels may reflect not only oxytocin but also fragments or metabolites of oxytocin [ 75 , 76 ]. It is particularly relevant to this review that some studies using ELISA have not found the physiological oxytocin elevations that occur with advancing gestation or during breastfeeding, which are clearly seen with RIA (See Uvnas Moberg 2019, 2020 for systematic reviews) [ 1 , 2 ]. The type of assay used in each study is listed in the tables, and the type of assay was also considered when interpreting the data.

Oxytocin sampling techniques are another critical quality assessment consideration. The short pulses of oxytocin that are released during labour and birth are best detected with frequent, rapid sampling at short intervals. However, it is not simple to take multiple blood samples from labouring women, especially in late labour. Therefore, samples tend to cluster at the start of labour, with fewer samples at the end. Sampling frequency and timing is listed in each table and is also considered in the interpretation of the data. A more detailed consideration of plasma oxytocin sampling techniques is presented in a previously published review [ 1 ].

The included papers also used a variety of measures of plasma oxytocin levels, including microunits per millilitre (μU/mL), picograms per millilitre (pg/mL) and picomoles per litre (pmol/L or pM). To facilitate comparisons between studies, we converted all results to picograms per millilitre (pg/mL), which is the most commonly-used measure. Data is also listed in the original units, and conversions are provided in the table legends. (See also Uvnäs-Moberg (2019) for a comprehensive conversion table [ 1 ].)

The characteristics of the 35 included studies are listed in Table  2 : ‘Characteristics of included studies.’ All other details including results are listed in Table  3 : ‘Maternal synthetic oxytocin administration: maternal plasma oxytocin levels’ and Table  4 : ‘Maternal synthetic oxytocin administration: newborn cord blood and maternal plasma oxytocin levels.’

Results are also presented in text below, and both tables and text are grouped according to patients sampled (women, newborn); time and method of synthetic oxytocin administration (before labour, in labour, postpartum); and timing and frequency of plasma sampling.

In addition, Table  5 : ‘Synthetic oxytocin dose regimens, maternal levels and total dose calculations’ presents a summary of several relevant studies to allow comparisons of dose-response data.

Effect of administration of synthetic oxytocin on maternal plasma oxytocin levels

Administration of synthetic oxytocin before labour.

Fuchs and colleagues (1991) administered a single intravenous bolus of synthetic oxytocin to 18 pregnant women at term at doses of 2, 4, 8 or 16 milliunits (mU) [ 5 ]. Boluses of 4 mU or higher caused significant, peak-shaped elevations of maternal plasma oxytocin at 1–2 minutes after administration. Oxytocin peak levels were similar to levels during spontaneous pulses in labour, as measured in this study. This bolus administration of synthetic oxytocin gave rise to uterine contractions in most women. At each dose level (2, 4, 8 or 16 mU) the average number of contractions during the first 10 minutes was correlated with mean peak maternal oxytocin levels.

Administration of synthetic oxytocin to induce or augment labour

Intravenous infusion of synthetic oxytocin.

Dose-response data

Six studies (reported in seven publications) reported maternal plasma oxytocin levels in relation to differing, specified infusion rates of synthetic oxytocin to induce or augment labour [ 42 , 43 , 50 , 51 , 61 , 65 , 70 ]. Dose-response relationships between the rate of infusion of synthetic oxytocin and maternal plasma oxytocin levels in these studies are reported in Table  3 .

Infusion rates in labour varied from 1 to 2 to 32 milliunits per minute (mU/min). In one study, the theoretical maximum dose was 42 mU/min but the actual mean maximum was 22.8 mU/min [ 61 ]. A linear relationship was found between the infusion rate and maternal plasma oxytocin levels in all studies. Doubling the infusion rate caused an approximate doubling of oxytocin levels, clearly seen in Fuchs (1983) [ 50 ]. Doubling the infusion rate approximately tripled levels in Furuya (1988), although numbers were small and data less clear in this Japanese-language study [ 51 ].

Several of these dose-response studies also measured plasma oxytocin levels in women without synthetic oxytocin infusions, allowing a comparison between oxytocin levels during normal (physiological) birth and with infusions of synthetic oxytocin. For example, Fuchs (1983) measured oxytocin levels during spontaneous labour and birth and found that oxytocin levels rose progressively, increasing from around 20 pg/mL at less than 2 cm cervical dilation (cm) to 46 pg/mL at 10 cm (full dilation). In the same study, synthetic oxytocin infusions at 7–9 mU/min increased oxytocin levels from pre-induction levels (around 17 pg/mL) to 59 pg/mL, within the range of levels in late spontaneous labour. At the higher infusion rate of 10–16 mU/min, maternal plasma oxytocin levels were doubled to 110 pg/mL, which is around twice maximum oxytocin levels in women in late spontaneous labour in this study [ 50 ].

Comments: dose-response data

These studies contribute significantly to this review as they are very well structured, include many samples and use reliable assays.

These studies also valuably illustrate the influence of assay sensitivity on oxytocin levels. In assays that give very low basal levels, for example, Amico (1984)/Seitchik (1984) and assay Ab-1 in Amico (1986), the rise of oxytocin levels was observable in response to low infusion rates (1–4 mU/min) and gave a consistent dose-response relationship [ 42 , 43 , 65 ]. In contrast, assays that gave higher basal oxytocin levels such as Fuchs (1983) and assay Ab-2 in Amico (1986) tended to mask the small oxytocin increases at low infusion rates [ 43 , 50 ]. However, elevations were seen at higher infusion rates in Fuchs (1983) [ 50 ]. See Table  3 for full details.

Sporadic measurements without dose-response data

Nine studies reported one or more maternal plasma oxytocin levels in labour in relation to different infusion rates of synthetic oxytocin (between 2 and 32 mU/min) but data in these studies was insufficient to allow dose-response calculations [ 20 , 46 , 56 , 58 , 59 , 62 , 64 , 66 , 71 ].

In five of these nine studies, women administered synthetic oxytocin in labour (doses not clearly reported) had plasma oxytocin levels that were approximately doubled compared to basal (pre-labour) levels or to levels in women without synthetic oxytocin [ 20 , 56 , 58 , 66 , 71 ].

In three studies, no elevation of plasma oxytocin was found in response to administration of synthetic oxytocin [ 46 , 62 , 64 ]. However, these studies also did not detect any oxytocin rise during labour in women without synthetic oxytocin, suggesting that the assay sensitivity was insufficient to detect the differences in oxytocin levels, and/or that the synthetic oxytocin dosage was very low. This may also apply to Padayachi (1988), who found a small oxytocin rise for women administered synthetic oxytocin but no rise during labour without synthetic oxytocin [ 59 ]. See Table  3 for full details.

Comments: sporadic measurements

These studies lack detail in relation to infusion rates of synthetic oxytocin and involve assays of differing sensitivity and quality. However, the data support the findings from dose-response curves that administration of synthetic oxytocin raises maternal plasma oxytocin levels only moderately: up to doubled levels in most studies.

Oxytocin patterns during a single contraction cycle

Using frequent sampling, Arai (1980) sampled maternal plasma oxytocin four times during single contractions in women labouring without interventions and women administered synthetic oxytocin [ 20 ]. Intrauterine pressure was simultaneously monitored.

In women without administration of synthetic oxytocin or other interventions, plasma oxytocin levels varied during contractions. Perhaps unexpectedly, maximal oxytocin levels were observed between contractions, with the lowest oxytocin levels coinciding with the contraction peak. However, in women administered infusions of oxytocin, this fluctuating pattern was not observed. Plasma levels were lower between contractions and the pattern was more flat, consistent with the constant infusion. See Table  3 for detailed data.

Buccal administration of synthetic oxytocin 

Dawood and colleagues (1980) studied the effects of buccal administration of synthetic oxytocin to induce or augment labour on maternal plasma oxytocin levels [ 45 ]. (Buccal administration involves synthetic oxytocin being placed adjacent to the buccal mucosa in the mouth, between the cheek and teeth.) Relatively high doses were used in this study: 400 IU every 20 minutes. Buccal absorption was very low and peak plasma levels were highly variable (6.8–181 pg/mL). Buccal administration has since been discontinued due to its low and unpredictable rate of absorption.

Administration of synthetic oxytocin postpartum

Nine studies (reported in twelve publications) reported maternal plasma oxytocin levels in response to postpartum synthetic oxytocin administration [ 47 , 49 , 52 , 54 , 55 , 57 , 68 , 69 , 70 , 72 , 73 , 74 ].

Four of these studies reported maternal oxytocin levels during post-caesarean intravenous infusions at different rates and duration [ 47 , 72 , 73 , 74 ]. Fuchs and colleagues (1982) reported similar data following vaginal birth, also published in Husslein (1983) [ 49 , 55 ]. Thornton and colleagues (1988) reported maternal plasma levels following postpartum intramuscular injection of synthetic oxytocin, and Gibbens and colleagues (1972) reported maternal plasma oxytocin levels following synthetic oxytocin administered by intramuscular, intravenous or subcutaneous injection [ 52 , 69 ]. Thornton (1990) administered synthetic oxytocin by intravenous infusion experimentally to women at eight to ten weeks postpartum [ 70 ].

One study, reported in three publications (Handlin (2009) and Jonas (2009) and more recently reanalysed by Takahashi and colleagues, (2021)) described plasma oxytocin levels during breastfeeding 2 days postpartum in relation to postpartum intramuscular injection of synthetic oxytocin and also in relation to intravenous infusion during labour [ 54 , 57 , 68 ]. This study, and the three publications, are discussed in detail below: ‘Administration of synthetic oxytocin with later postpartum sampling: exposed vs. unexposed analysis.’

Intravenous administration

Fuchs and colleagues (1982) measured plasma oxytocin levels in healthy women who were administered an infusion of synthetic oxytocin following vaginal birth at 100–150 mU/min, with the infusion rate decreasing over 2 hours (total dose 12–18 IU) [ 49 ]. Plasma oxytocin levels in women receiving this infusion were almost ten times higher at 30 minutes postpartum than corresponding levels in unmedicated women (275 vs. 29 pg/mL) and were still elevated at 2 hours (127 vs. 29 pg/mL), when infusion rates had declined.

Gibbens and colleagues (1972) administered synthetic oxytocin (5 IU, with ergometrine 0.5 mg) by intravenous injection to 14 women following vaginal birth and took frequent samples for up to 90 minutes [ 52 ]. Oxytocin levels rose rapidly from undetectable (less than 1.5 pg/mL) pre-injection to 550 pg/mL (mean) at 3 min, then fell rapidly. There was a more prolonged decrease after 6 minutes, and oxytocin was not detectable at 60 minutes in any woman. Initial half-life was calculated as 3 minutes from this data. Individual women’s oxytocin levels peaked as high as 700 pg/mL at 40–60 seconds in this study.

Yamaguchi and colleagues (2011) reported maternal plasma oxytocin levels following synthetic oxytocin infusions to healthy women after pre-labour caesarean who were randomised to three different regimes: 10 IU over 30 minutes (equivalent to 333 mU/min); 10 IU over 3 minutes (3333 mU/min); and 80 IU over 30 minutes (2666 mU/min) [ 73 ]. Plasma samples were taken at basal (pre-caesarean) and 5, 30 and 60 minutes after the infusion commenced in each group. Plasma oxytocin levels were analysed with ELISA, which gives higher levels than RIA. Maternal oxytocin rose rapidly in all groups, reaching approximately 50% of maximum levels by 5 minutes. Women who received 80 IU over 30 minutes (2670 mU/min, group c) had oxytocin levels that were 5-fold higher at 5 and 30 minutes than those administered 10 IU over the same period (330 mU/min, group a). When 10 IU was given more rapidly over 3 minutes (3330 mU/min, group b), plasma levels increased 50-fold from basal at 5 minutes. Plasma oxytocin levels were still around 10-fold elevated over basal at 60 minutes in all groups, including women administered 10 IU over 3 minutes. No haemodynamic side-effects were detected at any dose. See Table  3 for detailed data.

Velandia (2012) measured oxytocin levels after pre-labour caesarean in mothers and fathers randomised to 25 minutes of skin-to-skin contact (SSC) with their newborn babies or not, following 5 minutes of maternal SSC [ 72 ]. All women had received intravenous synthetic oxytocin 5 IU after birth, and half of the women received an additional 50 IU infusion over 1.5–2 hours postpartum. All groups showed small elevations in plasma oxytocin over the first hour, but this rise was only significant in those women with SSC who also received additional synthetic oxytocin. In these women, mean levels peaked at 64 pg/mL at 20 mins, compared to 35 pg/mL basal.

Yuksel and colleagues (2015) measured oxytocin levels following pre-labour caesarean in women randomised to SSC and breastfeeding with their newborns either immediately (in the operating room) or after 1 hour delay [ 74 ]. All women received synthetic oxytocin 5 IU by intravenous bolus followed by 20 IU/hour infusion. Maternal plasma was sampled for oxytocin levels (ELISA assay) before spinal anaesthesia was administered and again at 15 minutes post-caesarean. Women with immediate SSC had significantly higher oxytocin at 15 minutes (670.0 pg/mL) compared with women with delayed SSC (363.3 pg/mL) ( p  = 0.003). See Table  3 for full details.

In an experimental study, Thornton and colleagues (1990) administered low-dose synthetic oxytocin infusion to women at 8–10 weeks postpartum at 2.6 mU/min, increased to 5 mU/min after 30 minutes [ 70 ]. This approximate doubling of the infusion rate increased mean plasma oxytocin levels 1.5-fold (5.2 to 8.0 pg/mL).

Intramuscular injection

Thornton and colleagues (1988) sampled plasma oxytocin levels frequently (every 30 seconds for 15 minutes) in women with and without an intramuscular injection of synthetic oxytocin (5 IU in combination with ergometrine 0.5 mg, ‘Syntometrine’) at delivery of the baby’s anterior shoulder [ 69 ]. Oxytocin levels rose over several minutes from basal 3–16 pg/mL to a mean peak of 30 pg/mL. Among the women not administered synthetic oxytocin, six out of 15 had “remarkably similar” levels and patterns of oxytocin release, with a rise from 3.2 to 6.4 pg/mL and a mean peak of 11.6 pg/mL, whereas nine women (two-thirds) had no significant rise. The presence or absence of SSC was not reported.

Gibbens and colleagues (1972) also measured plasma oxytocin levels at frequent intervals following Syntometrine (5 IU synthetic oxytocin with 0.5 mg ergometrine) intramuscular injection [ 52 ]. Oxytocin was detectable in plasma from as early as 30 seconds, and average levels showed a gradual rise, with a wide peak (50 pg/mL) from 3 to 12 minutes. Oxytocin plasma levels remained elevated above basal (less than 1.5 pg/mL) for 30 minutes in all women, and as long as 60 mins in several women. There were no measurements of plasma oxytocin levels in untreated women in labour or postpartum for comparison in this study.

Comments: postpartum synthetic oxytocin

Postpartum intravenous infusions of synthetic oxytocin involved higher infusion rates, giving higher maternal plasma oxytocin levels, than during labour (see Tables  3 and 5 ). However, the duration of the postpartum infusion was generally shorter, so the total postpartum dose of synthetic oxytocin following vaginal birth (12–18 IU intravenous) was generally comparable to the intrapartum dose in the included studies. Frequent sampling following a 5 IU IV bolus after vaginal birth found very high but transient oxytocin elevations. Plasma oxytocin showed a slower and lower response to intramuscular injection of synthetic oxytocin (5 IU with 0.5 mg ergometrine) following vaginal birth [ 52 , 69 ]. Total postpartum doses of synthetic oxytocin administered following caesarean (5–55 IU) tended to be higher than total postpartum doses following vaginal birth (5–18 IU).

Administration of synthetic oxytocin with later postpartum sampling: exposed vs. unexposed analysis

Jonas and colleagues (2009), also reported by Handlin and colleagues (2009), sampled oxytocin levels frequently during a breastfeeding episode two days after birth in primiparous women grouped according to medical interventions in labour and birth, including synthetic oxytocin administered by intravenous infusion during labour and by intramuscular injection (10 IU) postpartum [ 54 , 57 ]. A subset of this data was reanalysed by Takahashi (2021) [ 68 ].

Jonas/Handlin report median total doses of intrapartum and intramuscular postpartum synthetic oxytocin as 0.9 IU and 10 IU respectively, and the Takahashi subset reported 1.1 IU intrapartum and 10 IU postpartum total doses [ 54 , 57 , 68 ]. Analysis was performed using ELISA, and data allowed analysis of dose-exposure relationships, as well as interactions between synthetic oxytocin and other interventions.

The combination of synthetic oxytocin with epidural analgesia was associated with significantly lower oxytocin levels throughout the breastfeeding episode, compared to women with neither exposure. There was also a dose-response pattern, with a higher amount of synthetic oxytocin infused in labour (with epidural co-intervention) associated with lower oxytocin release in women during breastfeeding. Women who received only a postpartum intramuscular injection of synthetic oxytocin, without synthetic oxytocin or other interventions in labour, had oxytocin levels and patterns during breastfeeding that were equivalent to women without any obstetric medications.

These findings were confirmed in a re-analysis by Takahaski and colleagues (2021), which found the lowest mean oxytocin levels during breastfeeding in women with epidural and synthetic oxytocin vs. synthetic oxytocin alone ( p  < 0.005) or controls ( p  < 0.005).

Similarly, this analysis found no significant difference in mean plasma oxytocin levels between women with and without a postpartum intramuscular injection (10 IU) of synthetic oxytocin (both groups had no intrapartum synthetic oxytocin infusions).

Comments: synthetic oxytocin with later postpartum sampling: exposed vs. unexposed analysis

The low intrapartum total doses in these study (0.8–1.1 IU) would not be expected to raise maternal plasma oxytocin significantly above physiological levels, according to data in this review. However, the data from women exposed to epidural analgesia in addition to synthetic oxytocin during labour suggest that this combination may have significant impacts on postpartum maternal oxytocin systems. (The effects of epidural analgesia on maternal and newborn plasma oxytocin levels will be reported in an upcoming systematic review.) It is of interest that postpartum intramuscular administration alone (10 IU) did not affect oxytocin release during breastfeeding on day two postpartum.

Administration of synthetic oxytocin with later postpartum sampling: combined exposed-unexposed analysis

At four to five days postpartum, Erickson and colleagues (2020) measured plasma oxytocin levels twice during a breastfeeding episode (basal and at 20 minutes) in 46 women: 11 had received synthetic oxytocin for labour augmentation, 33 received synthetic oxytocin postpartum (dose not stated) and 18 received epidural analgesia [ 48 ]. Analysis was performed using ELISA. Levels were not compared between exposed and unexposed women and data was not available to make this comparison. A higher total dose of synthetic oxytocin for labour augmentation (mean 1.3 IU) was reported to be significantly correlated with higher basal oxytocin levels ( p  = 0.03). Details of the correlation were not provided, and epidural analgesia exposure was not reported in this correlation.

At 2 months postpartum, researchers measured plasma oxytocin levels in a single blood sample taken during a home visit in women with varying exposure to synthetic oxytocin in labour and postpartum. Data was reported in two publications with large and seemingly overlapping populations, but with somewhat different analysis [ 53 , 63 ]. Neither study compared oxytocin levels in exposed vs. unexposed women.

Prevost (2014) included only synthetic oxytocin administered by intravenous infusion for labour augmentation, with the total synthetic oxytocin of approximately 0.58–3.02 IU (mean total doses reported in four groups, extracted from Table  2 in the publication) [ 63 ]. In contrast, Gu (2016) included synthetic oxytocin administered both by labour infusion (2–20 mU/min) and postpartum by intramuscular injection, stated as 50 IU [ 53 ]. The total synthetic oxytocin dose was reported as 36 IU. Analysis was performed using ELISA in both studies. Both studies reported significant positive correlations between maternal basal plasma oxytocin levels and synthetic oxytocin total dose, which accounted for 2.2% of the variance in maternal oxytocin levels in Gu (2016). Gu (2016) also found more self-reported depressive, anxious, and somatisation symptoms in women with higher dose-exposure to synthetic oxytocin, which accounted for 4.7% of the variance in these symptoms.

Comments: synthetic oxytocin with later postpartum sampling: combined exposed-unexposed analysis

The low intrapartum infusion rates in these two studies would not be expected to raise maternal plasma oxytocin significantly above physiological levels, according to data in this review. Longer-term direct impacts on basal oxytocin levels are therefore biologically unlikely. This is also suggested by the small influence (2.2%) of synthetic oxytocin on variance in maternal oxytocin levels. Note also that a single blood sample may not be a reliable measure of maternal plasma oxytocin levels, which varied 70-fold, as reported in Gu (2016).

In relation to postpartum dosage, Gu (2016) reported a non-standard intramuscular dose of 50 IU, which is significantly higher than usual practice (5–10 IU) or manufacturer recommendations [ 29 ].

In addition, the reported 25-fold difference in synthetic oxytocin exposure was associated with similar maternal plasma oxytocin levels at 2 months postpartum, with means of 281.02 pg/mL (Prevost) and 286.3 (Gu). The reported influence on maternal mental health symptoms was small (4.7%), suggesting that factors other than synthetic oxytocin exposure may be more influential.

Administration of maternal synthetic oxytocin and newborn plasma oxytocin levels

Six studies were identified that measured oxytocin levels in the umbilical cord blood of newborns whose mothers were administered synthetic oxytocin [ 44 , 58 , 59 , 60 , 62 , 67 ]. (Table  4 ) Five studies involved intrapartum infusions of synthetic oxytocin, including one study with buccal as well as intravenous synthetic oxytocin [ 44 ]. One study measured newborn levels following maternal intramuscular injection at the birth of the baby [ 67 ].

All six studies separately reported the results from the umbilical artery (UA), which carries blood from fetus to placenta, and umbilical vein (UV), which carries blood from placenta back to the fetus. All studies also included newborns whose mothers did not receive synthetic oxytocin. In three studies, maternal plasma oxytocin levels were also measured in late labour, allowing comparison with newborn levels [ 58 , 59 , 62 ].

Newborns of women administered synthetic oxytocin infusions in labour

Newborn ua vs. uv levels.

Levels of oxytocin in the UA were higher than in the UV in all newborns of women without synthetic oxytocin exposure. The same pattern was also seen in four of the five studies of newborns of women with intrapartum synthetic oxytocin exposure [ 58 , 59 , 60 , 62 ]. However, Dawood (1978) found an inverse relationship, with UV higher than UA [ 44 ]. This reflected a much lower UA oxytocin compared to the control group, as discussed below.

Newborns of exposed vs. unexposed women

Of the studies that compared oxytocin levels (UA or UV) between newborns of women who had received or not received synthetic oxytocin in labour, four of five studies found no significant differences [ 58 , 59 , 60 , 62 ]. However, Dawood (1978) found much lower UA oxytocin in newborns whose mothers received synthetic oxytocin (24.6 pg/mL) compared to levels in newborns of unexposed women (116 pg/mL) [ 44 ].

Newborn vs. maternal levels

Three studies measured oxytocin levels in late labour in women with and without infusions of synthetic oxytocin, as well as in their newborns [ 58 , 59 , 62 ].

In relation to maternal levels, Otsuki (1983) reported maternal plasma oxytocin levels in second stage labour in women who were administered synthetic oxytocin (infusion rate not stated) that were more than double the levels in unexposed women ( p  < 0.001) [ 58 ]. However, newborn oxytocin UA or UV levels were not different in the newborns of these exposed women vs. unexposed women in this study.

Padayachi (1988) and Pochard (1986) both reported oxytocin levels in women administered infusions of synthetic oxytocin that were not significantly elevated above controls. (Padayachi: 10.1 pg/mL with synthetic oxytocin vs. 9.1 pg/mL without; Pochard 3.0 vs. 2.0 respectively.) Rates and duration of synthetic oxytocin infusions were not reported but expected to be in a similar range to other included studies. In both studies, newborn UA and UV oxytocin levels were not different in the newborns of exposed vs. unexposed women [ 59 , 62 ].

Anencephalic newborns

Of interest, Otsuki (1983) also included four women without synthetic oxytocin exposure who gave birth to newborns with anencephaly, a congenital condition that includes the absence of oxytocin-producing brain areas [ 58 ]. Newborn UA and UV oxytocin levels were below the level of detection, consistent with no oxytocin production, while maternal oxytocin levels were similar to levels in women with unaffected babies in this study.

Newborns of women administered postpartum intramuscular synthetic oxytocin

Sellers (1981) compared oxytocin levels in newborns of women who were exposed vs. unexposed to postpartum synthetic oxytocin by intramuscular injection (5 IU combined with 500 μg ergometrine with birth of the anterior shoulder) [ 67 ]. The timing of cord blood sampling following the injection was not stated. As in other studies, UA was significantly higher than UV ( p  < 0.05). Newborn UA and UV oxytocin levels were not different in the newborns of exposed vs. unexposed women.

Comment: newborn levels 

In these studies, newborn oxytocin levels were consistently higher than maternal levels, with the levels in the UA higher than the UV, which suggests fetal production of oxytocin in labour. Maternal infusions of synthetic oxytocin in labour did not influence newborn oxytocin levels. Anencephalic newborns were found to have undetectable oxytocin levels despite normal maternal levels, further suggesting that maternal oxytocin does not cross to the fetus in labour.

Synthetic oxytocin is very commonly administered to parturient women in current maternity care settings. This review is the first to summarise the effects of maternal intrapartum and postpartum administration of synthetic oxytocin on plasma levels of oxytocin in women and their newborns.

In these studies, maternal plasma oxytocin levels increased moderately in response to perinatal synthetic oxytocin infusions, with a dose-response pattern. Infusion rates of 10 mU/min or higher raised maternal oxytocin levels above the range seen in physiological labour. At maximum infusion rates (up to 32 mU/min), maternal oxytocin levels were 2–3-fold elevated compared to women in physiological labour. Newborn levels of oxytocin were higher than maternal and were higher in the umbilical artery than the umbilical vein, suggesting fetal production in labour. Oxytocin levels in newborns whose mothers received synthetic oxytocin in labour or postpartum were not higher than levels in newborns of unexposed women, suggesting that synthetic oxytocin is not transferred to the fetus in labour. Postpartum doses and maternal oxytocin levels were generally higher, but of shorter duration, compared to labour. Data analysed with RIA, especially studies involving serial samples, gave generally more coherent results than those using ELISA.

Study design and other methodological considerations

The studies in this review are exploratory studies describing pharmacological and biological responses to the administration of synthetic oxytocin during the major physiological processes of labour and birth, rather than randomised controlled trials to ascertain the outcome of a clinical intervention. However, these included studies are of high quality and are very valuable in illustrating pharmacological and physiological processes.

Labour is a long biological process with an unpredictable rate of progress and is therefore difficult to study. There is a high variability in individual endogenous oxytocin levels, partly due to the pulsatile release of oxytocin during labour [ 1 ]. This makes it necessary to take multiple blood samples, which involves ethics and expense, especially for high-quality RIA assays. The majority of included studies involve repeated samples analysed with the same well-validated RIA technique. (See previous systematic review for a more thorough discussion of methodological considerations in relation to plasma oxytocin sampling in labour [ 1 ]).

In relation to randomisation, it is difficult to standardise the administration of synthetic oxytocin through the course of labour because infusion rates must be individually adjusted to accommodate clinical factors such as labour progress, pain, and fetal tolerance. Co-interventions such as epidural analgesia may also impact maternal plasma oxytocin levels in labouring women [ 77 ]. (The effects of epidural analgesia on maternal and newborn plasma oxytocin levels will be reported in an upcoming systematic review.) Therefore, a randomised trial of synthetic oxytocin at different dosages in labouring women would be problematic and unlikely to provide cohesive data. It is noteworthy that the only study in this review in which dosage of synthetic oxytocin was randomised occurred in the well-controlled post-caesarean context [ 73 ].

Intrapartum synthetic oxytocin: maternal dose and oxytocin assays

The studies identified in this review are generally older, but the dose-regimens and infusion rates are similar to those used in current maternity care, as discussed below. This makes the maternal plasma oxytocin levels obtained in this review relevant to contemporary settings.

In the reviewed studies, starting rates were 1–3 mU/min, increasing to maximum 32 mU/min. Total doses of synthetic oxytocin administered during labour, reflecting infusion rate and duration, ranged from 0.5–15 IU, as stated in the studies or calculated from the data, based on maximum infusion rates continued for 8 hours (see Table  5 ). These calculated values are likely overestimated, as infusions are usually started at low rates and titrated upwards only when necessary.

Similarly, a recent study that analysed contemporary intrapartum dose regimens from 13 mostly European countries found starting infusion rates varying from 1 to 15 mU/min, with maximum rates between 15 and 30 mU/min in most regimens [ 78 ]. The highest maximum infusion rate was 60 mU/min, based on high-dose regimens in two countries. The authors of this study also calculated a total intrapartum dose of 2.38–27 IU (mean 8.97 IU), based on a theoretical 8-hour infusion and incorporating the starting rate, interval for rate increases, and maximum infusion rate. Again, these calculations are likely overestimations of the total doses used in clinical practice because infusion rate increases are titrated against clinical effects.

Most of the older studies included in this review analysed oxytocin levels with radioimmune assay (RIA), which remains the gold standard assay for oxytocin analysis. The RIA studies in this review showed consistency in both dose-response relationships and in comparisons between levels obtained in physiological birth and with synthetic oxytocin infusions. This allowed clear comparisons between studies and consistent interpretation of the data.

In contrast, most of the more recent included studies have used enzyme-linked immunoassays (EIA, ELISA), which are less specific for the oxytocin molecule compared to RIA, and the numerical values obtained with ELISA are higher and less consistent [ 38 , 76 ]. For example, Ende (2019) found no rise in maternal plasma oxytocin using ELISA at one-hour post-caesarean in response to intraoperative intravenous administration of (mean) 14 IU synthetic oxytocin, whereas Yamaguchi (2011), also using ELISA, found 10-fold elevation at 1 hour post-caesarean following 10 IU infused over 30 minutes [ 47 , 73 ]. Included studies that have reported results from a single sample and also used ELISA for analysis are particularly difficult to interpret [ 53 , 63 ].

The trend towards the use of ELISA in more contemporary maternity-related studies, compared to the “well validated, but more laborious” RIA [ 38 ] used in the older studies, may have fostered misconceptions regarding oxytocin levels in response to synthetic oxytocin and the possibility of direct biological impacts on mother and/or offspring. Models of oxytocin physiology have been developed that are not anchored in the original, detailed knowledge and understandings of oxytocin release in childbirth and the pharmacological effects of synthetic oxytocin, as seen from the RIA studies this review.

In particular, the pharmacokinetic properties of synthetic oxytocin remain poorly understood, despite its widespread administration to labouring women.

Synthetic oxytocin: pharmacokinetics

Older data, based on labelled (tritiated) synthetic oxytocin (5 IU) administered intravenously mid-pregnancy, and on in-vitro measurements, suggested a half-life of 5 minutes in pregnant women [ 79 , 80 ]. One included study by Gibbens found a half-life of 3 minutes following postpartum synthetic oxytocin intravenous bolus (5 IU), with a considerably slower decline after this initial rapid decrease [ 52 ]. However, steady-state calculations (discussed below), including in the reviewed studies by Seitchik (1984) and Amico (1984), suggest a longer half-life of 8–10 minutes for synthetic oxytocin, at least in labouring women [ 42 , 65 , 81 ].

Outside of pregnancy, Amico calculated a half-life of 12–17 min (mean 15.3) in four men administered synthetic oxytocin infusion at 125 mU/min [ 42 ]. In other high-quality data, Legros and colleagues found a slower decline in men following 8 mU/min infusion, with data suggesting a half-life of around 20 mins [ 82 ]. In a very detailed pharmacokinetic study, Nielsen administered synthetic oxytocin (10 IU bolus) to postmenopausal women and reported a more complex 2-compartment model of distribution, with half-lives of 5.5 minutes and 1.2 hours respectively [ 83 ].

The half-life could be shorter in labour due to enhanced placental production of a specific oxytocinase, placental leucine aminopeptidase (P-LAP). This enzyme rapidly degrades oxytocin and enzyme levels are increased up to 10-fold in late pregnancy [ 84 ]. In one included study, Thornton and colleagues found a four-fold lower plasma oxytocin response to synthetic oxytocin dosage and a higher metabolic clearance rate (MCR) in pregnancy vs. postpartum, suggesting effects from P-LAP, although half-life was not calculated [ 70 ]. Others have not found differences in MCR in pregnant vs. non-pregnant context [ 85 ].

Synthetic oxytocin product information sources give wide ranges of values for oxytocin half-life (e.g. 3–20 minutes), reflecting this lack of precise data [ 29 , 86 ].

Steady state is another important pharmacokinetic concept. This reflects the time from a dose increase until ‘steady state’ is reached: that is, when input and degradation are balanced. Steady state is generally 3–4 times the half-life, according to basic pharmacokinetic rules. If dose levels are very high and metabolism cannot keep pace with input, drug accumulation will occur. There was no evidence in the included studies for accumulation of oxytocin at the doses of synthetic oxytocin used.

In relation to synthetic oxytocin, both Amico and Seitchik found that steady-state was reached at 30–40 minutes after an increase in infusion rate, which is similar to steady-state calculations performed by Dawood, and fits with a half-life of 8–10 minutes [ 42 , 65 , 81 ]. Similar estimates of half-life and steady state are provided by more contemporary sources [ 87 , 88 , 89 ]. This suggests that it may be more effective to gradually increase synthetic oxytocin infusion rates and titrate this against individual uterine effects, using intervals of 30–40 minutes.

The consistent dose-response curves and other pharmacokinetic data across the included studies show a linear increase in oxytocin levels with each increase in the infusion rate (Table  3 ). These findings are also consistent with manufacturer data and recommendations, and similar data has been reported outside of pregnancy [ 29 , 82 , 83 ].

It is also interesting to note that early clinicians saw benefit in using the lowest infusion rate possible and staying within the range of physiological oxytocin levels, which this data suggests is 9 mU/min or less. Similarly, lowering maximum infusion rate to 10.9 mU/min was found to improve induction outcomes in a recent US-based quality improvement project [ 90 ]. Clinicians have also trialled a pulsed infusion of synthetic oxytocin for induction or augmentation, which was found to substantially reduce the total dose administered without loss of efficacy in most studies, and may deserve further exploration [ 81 , 91 , 92 , 93 , 94 , 95 ].

Pharmacokinetics and clinical use

According to the physiological model, as presented in Fig.  1 , the infusion rate and the ensuing plasma oxytocin levels will influence the uterine response (and subsequent metabolic, autonomic and hemodynamic effects) more than the total amount (total dose) of synthetic oxytocin. (Note that the total dose may be high when infusions are prolonged, but the rate of infusion may still be low.)

It is also important to note that the sensitivity of the pregnant woman’s uterus to oxytocin increases substantially towards term, due to increases in oxytocin receptors and other activating processes [ 7 , 96 , 97 ]. According to one included study, the amount of synthetic oxytocin required to stimulate the uterus and augment labour can vary more than 5-fold, due to differences in sensitivity of the uterus and oxytocin receptors [ 42 ].

In addition, there is a biological limit to the infusion rate of synthetic oxytocin that can be safely administered in labour. An excessively high infusion rate will cause uterine hyperstimulation, with reduced blood flow that increases risks of hypoxia for the fetus and maternal metabolic and autonomic consequences as described in the physiological model (Fig.  1 ). The safe maximum infusion rate varies according to the reactivity of the individual woman’s uterus and the tolerance of her fetus to the effects of contractions, among other factors [ 98 ]. The maximum rate found in the included studies was 42 mU/min . Similarly, the highest recommended maximum infusion rate is 40 mU/min in contemporary protocols for active management of labour and 40–60 mU/minute in EU guidelines [ 78 , 99 ].

Postpartum synthetic oxytocin

In contemporary maternity-care, synthetic oxytocin is commonly administered by intramuscular injection (5–10 IU) to prevent postpartum haemorrhage (PPH) after vaginal birth. It may also be administered by intravenous infusion as a treatment for PPH following vaginal birth, or routinely following caesarean section. Postpartum infusions are generally administered at much higher rates than intrapartum infusions but are administered for a more limited time. The total postpartum dose (by intravenous infusion or intramuscular injection) following vaginal birth may therefore be similar to the total dose that is given over the duration of labour, as seen in several of these studies.

More recently, an intravenous bolus of synthetic oxytocin has been advocated as a more effective PPH preventative following vaginal birth than intramuscular administration [ 100 , 101 ]. A slow intravenous bolus of 10 IU is now recommended following vaginal birth, where feasible, by the World Health Organisation [ 36 ].

In this review, only one study was found that measured maternal plasma oxytocin levels following a postpartum intravenous synthetic oxytocin bolus (5 IU). Gibbens and colleagues (1972) found plasma oxytocin peaks up to 700 pg/mL in the first minute after administration [ 52 ].

Outside of maternity care, the pharmacokinetic study discussed above found plasma oxytocin peaks around 1300 pg/mL at 15 minutes, more than 70-fold above basal levels (17 pg/mL), in response to a 10IU bolus [ 83 ]. Peak levels would have been higher if samples had been collected immediately after injection. Oxytocin levels declined more slowly to basal over two to four hours, showing a similar two-phase disappearance to that found by Gibbens.

Given these high oxytocin levels in response to bolus intravenous injection, potential adverse effects should be considered when administered to women postpartum. Of particular concern, researchers have identified significant hemodynamic disturbances (well-recognised side effects of synthetic oxytocin) after administering 2.5–10 IU by intravenous bolus to healthy women following pre-labour caesarean. Some women have had indications of coronary vasoconstriction, likely because of the rapid oxytocin peaks in combination with the hemodynamic disruptions of regional anaesthesia [ 102 , 103 , 104 , 105 , 106 , 107 ]. These adverse effects may be less significant following vaginal birth, but they are an indication of the very high levels of oxytocin following intravenous bolus. The possible hemodynamic impacts of bolus intravenous synthetic oxytocin following vaginal birth in combination with epidural analgesia, or in women with cardiovascular vulnerabilities, may also require consideration before widespread adoption of routine postpartum intravenous bolus.

Newborn plasma oxytocin levels following maternal synthetic oxytocin administration

In this review, newborn oxytocin levels, as measured in cord blood, were consistently higher than maternal plasma oxytocin levels. In addition, oxytocin levels were consistently higher in the uterine artery (UA), which represents production by the fetus, than in the uterine vein (UV), which reflects processes in the placenta, including possible placental transfer and metabolism. These findings suggest that the human fetus has its own oxytocin production during labour and is consistent with understandings that the human fetus has a relatively mature oxytocin system at birth [ 108 , 109 , 110 , 111 ].

Lower UV oxytocin vs. UA also suggests that fetal oxytocin is metabolised in the placenta, likely by the high levels of placental oxytocinase, which may also contribute to reducing placental transfer [ 112 , 113 ].

In this review, no increase in newborn oxytocin levels was reported following maternal administration of synthetic oxytocin in labour, even in newborns whose mothers received high infusion rates, and had high oxytocin levels, in late labour (Table 4 ). Of interest, in one included study, Otsuki (1983) found no oxytocin in the cord blood of anencephalic newborns, who lack the brain centres that produce oxytocin [ 58 ]. This further suggests that oxytocin in the cord blood derives from the fetus and that oxytocin, whether endogenous or synthetic, is not transferred across the placenta.

Can synthetic oxytocin cross biological membranes?

These findings are in accord with biochemical understandings. Peptide molecules such as oxytocin are hydrophilic and do not readily cross biological membranes. It has been reported that 0.002–0.1% of plasma oxytocin can cross to the brain through the blood-brain barrier [ 114 , 115 , 116 ] and passage across the placenta is likely to be similarly limited. Significant transplacental passage would therefore require extremely high maternal levels (100-fold or more above physiological), which are not reached in labouring women administered synthetic oxytocin, according to this review. In addition, the P-LAP oxytocinase enzyme, produced by the placenta at the interface between fetal and maternal blood, may further prevent transfer of maternal oxytocin to the fetus by degrading the molecule on contact [ 117 ].

Direct studies of transplacental passage of synthetic oxytocin have had contradictory findings. Some of the conflicting data may be related to the experimental techniques used. For example, some in-vitro studies using human placentae have found a small and delayed transplacental passage, but placental oxytocinase and membrane barriers may be functionally reduced in this model [ 113 , 118 ]. In addition, oxytocin levels in the maternal compartment (perfusate) in these models are significantly higher than the maternal levels found in this review in response to synthetic oxytocin administration [ 113 ].

Of note, a detailed in-vivo sheep model, which involved fetal and maternal instrumentation and direct blood sampling, did not show passage of an intravenous infusion of synthetic oxytocin from mother to fetus, or from fetus to mother [ 119 ].

Dose-exposures in animal models

Offspring biological effects from perinatal synthetic oxytocin exposures have been demonstrated in animal models. These findings are often used as evidence to support the passage of synthetic oxytocin to the human fetus at clinically-relevant doses, and even to the fetal or newborn brain. However, to further understand the relevance of such animal studies to human synthetic oxytocin exposures, it is necessary to understand the comparative dose-exposures.

Animal dose-exposures can be calculated from published data and compared to the dose-exposures for women and newborns, as seen in this review. (See legend in Table  3 for oxytocin conversions.) For example, in the in-vivo sheep model discussed, the maternal infusion rates administered (0.8 and 0.08 mU/min per kilogram) correspond to clinically relevant infusion rates of 5.6–56 mU/min for a 70 kg (kg) pregnant woman and caused uterine contractions in the pregnant ewe. In this model, there was no passage of synthetic oxytocin from mother to fetus [ 119 ].

In other animal models, researchers have exposed prairie vole fetuses indirectly to synthetic oxytocin via maternal administration in late pregnancy, or directly administered synthetic oxytocin to newborns, and studied offspring neurobiology and development.

Dose-exposure calculations show that this animal data cannot be compared to human perinatal exposures because of the extremely high doses of synthetic oxytocin that are administered. Bolus doses administered to pregnant prairie vole dams of 0.03 to 0.5 mg (18–300 IU) per kilogram are equivalent to 1260–21,000 IU for a 70 kg pregnant woman [ 120 ]. Typical boluses administered to newborn voles of 0.03-3 mcg to 1-8 mg/kg to a 2g newborn are equivalent to 90-4800 IU per kg, corresponding to 720–14,000 IU administered to a 3 kg human newborn [ 121 ]. These doses are one hundred- to ten thousand-fold higher than the total doses that women receive in labour (Table  5 ). Such extreme doses could not be administered clinically because of the sensitivity of the human uterus to oxytocin, associated with the large increase in oxytocin receptors at term [ 7 ]. These doses would cause uterine hyperstimulation and endanger the fetus, as well as causing adverse maternal hemodynamic effects, as discussed.

However, these high animal-model doses of synthetic oxytocin will certainly produce very high plasma oxytocin levels, with even more extreme peaks with bolus administration. The likely 0.1% transplacental and blood-brain passage could undoubtedly induce biologically significant effects for the fetus or newborn. In these studies, vole offspring who received these exposures directly or indirectly via maternal administration had enhanced adult social and parental behaviours, compared to offspring of untreated dams, along with changes in brain oxytocin and other hormonal systems [ 120 , 121 ]. These findings suggest positive biological effects on offspring oxytocin systems from very high-dose exposures in the perinatal period.

In other studies, rat dams administered similarly high doses of synthetic oxytocin in early pregnancy had less body fat at the end of pregnancy and gave birth to larger offspring with bigger placentas than untreated dams [ 122 ]. Newborn rat pups directly administered similar doses to newborn voles had more tolerance to stress and pain in adulthood compared to untreated offspring, indicating that the oxytocin system was positively modified by these high exposures [ 123 , 124 ].

It has also been suggested that synthetic oxytocin might cross the maternal blood-brain barrier in labour or postpartum and directly impact central maternal oxytocin functioning, including possible associations with maternal postpartum mental health [ 125 , 126 ].

This model has several limitations. As noted, 0.1% of plasma oxytocin is estimated to cross into the brain. This review found that the doses of synthetic oxytocin administered in labour cause maternal plasma oxytocin elevations 2–3-fold above levels in physiological labour, which would be insufficient to cross to the brain and influence central processes.

In support, primate research found that synthetic (labelled) oxytocin administered by intravenous bolus does not cross into brain tissue, even at high bolus doses of 40-80 IU. These large boluses produced very high plasma levels (mean 1992 ± 476 pg/ml) and small elevations in CSF (below the level of quantification) as predicted by low passage through the blood-brain barrier [ 127 ].

Animal studies have suggested an active transport mechanism into the brain using RAGE (receptor for advanced glycation end- products), based on high bolus doses of synthetic oxytocin (e.g. 0.65 IU/kg) which could not be safely administered to women in labour. At such doses, oxytocin could also pass directly into the brain via the blood-brain barrier. In addition, afferent stimulation of sensory nerves by peripheral oxytocin could also promote central oxytocin release [ 128 , 129 ].

For these reasons, it is not accurate to compare the plasma levels, or the effects, of infusion of microunits of synthetic oxytocin, as used in clinical maternity care, with animal studies administering milligram doses. At these high milligram doses, passage through membranes can occur, but this does not occur at the lower milliunits exposure that occurs in human labour and birth. Therefore, the data in this review do not support direct maternal or offspring biological effects, short- or longer-term, from the direct passage of synthetic oxytocin administered in labour or postpartum into the maternal brain.

Direct epigenetic effects on the oxytocin system have been demonstrated in animal offspring in response to very high peripartum exposures to synthetic oxytocin [ 120 ]. However, such effects are unlikely to occur for women and human offspring at the comparatively low dose-exposures and resulting low maternal oxytocin levels found in this review. In addition, a recent review found no evidence, thus far, of epigenetic effects from physiological childbirth in human studies and suggested, “oxytocin linked effects might be indirectly mediated via other receptors and signalling systems.” [ 130 ].

Alternative, indirect mechanisms for synthetic oxytocin biological effects

Some studies have suggested negative maternal and infant outcomes associated with maternal synthetic oxytocin administration, including reduced newborn pre-breastfeeding behaviours; delayed breastfeeding initiation; and shorter duration [ 131 , 132 , 133 , 134 , 135 , 136 , 137 ] (see Erickson (2017) for recent review [ 138 ]). Maternal postpartum mood and wellbeing has also been suggested to be negatively impacted, although not all studies have found negative maternal mental health outcomes [ 53 , 139 , 140 , 141 ]. (See also Kendall-Tackett for critique [ 142 ]). Such possible adverse effects may reflect indirect influences of synthetic oxytocin on mother and baby, including via changes in the quantity and quality of uterine contractions.

Possible indirect effects: maternal

Infusion of synthetic oxytocin in labour at clinically high doses causes stronger and more frequent uterine contractions, with shorter periods of relaxation between contractions, compared to physiological labour [ 29 , 30 , 31 ]. Strengthening of contractions exacerbates the metabolic effects within uterine muscle (illustrated in Fig.  1 ) including by further reducing blood flow, increasing lactic acid levels and reducing pH. In addition, reduced intervals between contractions leaves less time for recovery within the uterine muscle, increasing the metabolic stresses. Sensory input from the uterus to the brain in response to these stresses generates pain sensations and shifts autonomic function further towards the stress-linked sympathetic nervous system (SNS). The release of endogenous oxytocin may be decreased as the contraction proceeds, due to SNS feedback [ 20 ]. (Note that this would be masked by synthetic oxytocin.) See Background for further details.

The processes of labour may eventually slow due to these metabolic, autonomic and possibly oxytocin-reducing effects. Doses of synthetic oxytocin are often increased to compensate this decline, which further exaggerates these metabolic stresses and consequences.

Note that perinatal synthetic oxytocin administration may influence endogenous oxytocin production or levels both negatively and positively. Negatively, as discussed and shown in Fig.  1 , oxytocin levels can be reduced due to SNS feedback in response to strong contractions. Positively, pressure on the cervix induces sensory feedback, which augments endogenous oxytocin levels via the Ferguson reflex. It is also possible that synthetic oxytocin might stimulate activity of the vagal nerve or other sensory nerves thereby stimulating central oxytocin release. By these mechanisms, synthetic oxytocin may, in some circumstances, stimulate some of the beneficial effects of endogenous oxytocin that occur during physiological labour and birth. (See Background for more details.)

This is consistent with positive effects for synthetic oxytocin reported in some circumstances. In one included study, Velandia (2012) reported that, following pre-labour caesarean, only those women who received postpartum 50 IU of intravenous synthetic oxytocin (in addition to standard 5 IU) released significant oxytocin during skin-to-skin contact with their newborns. Those women who received synthetic oxytocin also reported more positive personality changes at 2 days postpartum, including the lowest scores on detachment and somatic anxiety, compared to women without synthetic oxytocin [ 72 ]. (The effects of caesarean section on maternal and newborn plasma oxytocin levels will be reported in an upcoming systematic review.)

Positive effects have also been reported in relation to synthetic oxytocin administration with vaginal birth. In one included study, Handlin (2009) and Jonas (2009) found lower stress and anxiety and greater sociability in women with vs. without infusions of synthetic oxytocin in labour at very low doses (mean total dose 1.6 IU) [ 54 , 143 ]. Similarly, a more recent study found more positive postpartum personality traits in women with vs. without synthetic oxytocin, administered in labour at a (median) maximum infusion rate of 7.5 mU/min [ 144 ].

These potential benefits of synthetic oxytocin may especially apply when the endogenous oxytocin system has not been activated, such as following prelabour caesarean, although research is limited [ 145 , 146 ]. (See Jonas 2009 for further discussion [ 57 ].) Adverse impacts of synthetic oxytocin due to other mechanisms or co-interventions also need to be considered, as discussed above.

Whether synthetic oxytocin has harmful or beneficial impacts likely depends on the intensity of uterine contraction patterns. Stronger and more frequent contractions caused by synthetic oxytocin can increase physiological stresses that may increase SNS activation and shift the ANS balance towards the SNS and stress (Fig.  1 ). Longer-term negative impacts by such contractions on maternal physiology are biologically plausible.

Postpartum administration: possible indirect effects

The pharmacological effects of synthetic oxytocin on maternal physiology will differ when administered postpartum compared to intrapartum. Postpartum contractions are shorter in duration and less frequent compared to intrapartum contractions, even when synthetic oxytocin is administered postpartum [ 147 , 148 ]. These relatively shorter and less frequent contractions give more time, within the uterine muscle, for acidity and lactic acid to clear and tissue stresses to reduce. Adverse impacts via maternal metabolic and autonomic effects including SNS activation (Fig.  1 ) are therefore less likely following postpartum vs. intrapartum synthetic oxytocin.

However, the dosage and route of administration of postpartum synthetic oxytocin, and the resulting oxytocin levels and patterns will also be important factors. Adverse haemodynamic or other effects are also possible. (See ‘Pharmacokinetics and clinical use’, and ‘Postpartum synthetic oxytocin’). Note also that other oxytocic drugs including ergometrine and prostaglandins may have different pharmacological effects in the postpartum period, including possible adverse effects on lactation hormones [ 149 , 150 ].

Synthetic oxytocin and co-interventions

Investigation of possible maternal impacts from synthetic oxytocin may also require consideration of epidural analgesia, which is commonly co-administered to assist women with increased pain from the stronger contractions [ 151 , 152 ]. Epidurals may reduce the sensory feedback that drives the Ferguson reflex, causing oxytocin levels to decrease and contractions to slow [ 77 , 153 , 154 , 155 ]. To compensate, higher doses of synthetic oxytocin are often required [ 152 ].

In one included study, Jonas (2009) measured plasma oxytocin levels during early breastfeeding and found the lowest levels among women who received both synthetic oxytocin and epidural analgesia in labour [ 57 ]. A recent re-analysis of the data from this study has reinforced these findings, reporting no negative impacts on oxytocin release during early breastfeeding in women administered synthetic oxytocin in labour alone; that is, without concomitant epidural analgesia [ 68 ].

In addition, epidurals reduce the sensitivity of sensory nerves for both mother and newborn, potentially uncoupling the physiological interactions (mutual regulation) that guide mother and baby after birth and causing a ‘pharmacological separation’ [ 4 ]. (The effects of epidurals on maternal and newborn plasma oxytocin levels will be reported in an upcoming systematic review.)

Induction vs. augmentation

There may also be different maternal physiological effects from administration of synthetic oxytocin for labour augmentation vs. induction. In the present review, infusion rates and total doses were generally higher for induction than for augmentation, likely reflecting the reduced responsivity of the uterus before the physiological onset of labour, including fewer oxytocin receptors [ 7 ].

Longer-term effects on maternal psychological wellbeing have been reported following induction of labour [ 156 , 157 , 158 ]. This could relate to deficits in the full readiness of central oxytocin and other maternal systems. Some biological aspects of maternal-newborn bonding could also be affected, but human research is limited. In animal studies preparatory changes in the maternal brain may only occur in the last stages of pregnancy [ 159 ].

Induction also involves foreshortening of gestation, including of the full period of fetal brain development, with accumulating evidence of neurodevelopmental and educational deficits at earlier vs. later gestations, even up to 40-41 weeks [ 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 ].

It is also important to note that induction studies have generally not differentiated the method of induction (synthetic oxytocin, prostaglandins, mechanical methods), which may impact the consequences of induction. (The effects of prostaglandins on maternal and newborn plasma oxytocin levels will be reported in an upcoming systematic review.)

Oxytocin receptor considerations

Prolonged synthetic oxytocin administration in labour may lead to reduced uterine responsiveness and has been identified as a risk factor for postpartum haemorrhage in many studies [ 168 , 169 , 170 , 171 , 172 , 173 ]. It has been suggested that these well-recognised clinical effects reflect desensitisation (reduced binding) and possibly down-regulation (reduced numbers) of uterine oxytocin receptors [ 174 , 175 ].

It is unlikely that classical receptor desensitisation would occur in vivo in response to synthetic oxytocin administration in labour. As identified in this study, clinical doses produce relatively modest maternal oxytocin plasma levels (in the picomolar range). Researchers have determined that oxytocin receptor desensitisation occurs in vitro from 1 nanomole (nM) exposure, equivalent to 1000 pg/mL (see conversions in Tables  3 and 4 ) with maximal desensitisation at 1 μmol (μM) equivalent to 1,000,000 pg/mL [ 174 , 176 , 177 ]. These levels are 10- to 10,000-fold higher than levels measured in labouring women with high-dose synthetic oxytocin infusions, according to this review. Other in vitro research has found similarly high thresholds, with oxytocin receptor desensitisation only occurring at tissue oxytocin exposures above 10 − 8  M, equivalent to 10,000 pg/mL [ 178 ]. In addition, the desensitisation effects in these studies begin after 6 hours exposure and peak at 20 hours, which is a relatively long duration for synthetic oxytocin infusion.

Of note, these researchers also found reductions in receptor binding and density with the progress of physiological labour [ 174 ]. This may be due to the metabolic and autonomic effects described, including lactic acid build up and reduced pH within uterine tissues (Fig.  1 ), which could also reduce receptor functioning [ 17 , 19 ]. This raises the possibility that the reported negative effects of synthetic oxytocin on oxytocin receptors may represent an amplification of the metabolic effects of physiological labour, including greater increases in uterine lactic acid and acidity (Fig.  1 ). Such metabolic effects would occur more quickly than the classical desensitisation effects seen in vitro and will be greater with longer periods of infusion.

In support, researchers have shown benefits to labour outcome and newborn wellbeing in women diagnosed with labour dystocia from prior oral bicarbonate treatment [ 179 ]. This alkalinising treatment counteracts the lactic acid build up and pH reduction due to excessive uterine muscle activity (see Fig.  1 ), thereby improving myometrial function, likely including oxytocin receptor function. This metabolic model could account for some of the clinical effects of prolonged synthetic oxytocin administration, including the reduced effectiveness with long duration and the increased risks of postpartum haemorrhage.

Whether the negative effects of synthetic oxytocin on uterine activity reflect direct effects on oxytocin receptors or indirect metabolic effects that might also reduce receptor functioning, limiting the use, and especially dose, of synthetic oxytocin is likely to provide benefits for labouring women and their babies.

Possible indirect effects: fetus/newborn and offspring

For the offspring of women exposed to synthetic oxytocin in labour, researchers have suggested increased longer-term risks of adverse neurodevelopmental sequelae, including attention-deficit hyperactivity disorder (ADHD) and autism, compared to offspring of unexposed women [ 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 ]. Much of the evidence thus far for these negative outcomes is low-quality and differences are smaller or completely negated in large or more detailed studies or reviews [ 126 , 190 , 191 , 192 , 193 , 194 ].

As discussed, this review of studies measuring oxytocin levels in labouring women and newborns found no evidence that synthetic oxytocin, at clinical doses, crosses the placenta and elevates fetal/newborn oxytocin levels. In fact, the high newborn oxytocin levels found in all relevant studies in this review, including in newborns of women without synthetic oxytocin exposure, suggest that the human fetus is actively producing oxytocin in labour. Direct physiological effects of maternal synthetic oxytocin on the fetal oxytocin system are therefore extremely unlikely.

However, indirect effects are possible for the fetus/offspring, as for the mother, likely via changes in contraction patterns. Synthetic oxytocin causes contractions that are both stronger and more frequent, compared to contractions in physiological labour [ 30 , 31 , 195 , 196 ]. Both factors contribute to a greater reduction in blood flow to the fetus, giving exaggerated metabolic effects, compared to labour without synthetic oxytocin (Fig.  1 ).

Stronger synthetic oxytocin-driven contractions cause increased pressure on the placenta, reducing placental blood flow to the fetus during contractions. Researchers using Doppler ultrasound found 50% reduction in placental blood flow during contractions in women administered synthetic oxytocin or prostaglandins for labour induction, compared to 33% reduction in women during spontaneous labour. Blood flow was also reduced between contractions, although no adverse effects were detected on fetal heart rate monitoring in this study [ 197 ].

The higher frequency of contractions due to synthetic oxytocin can also be detrimental for the fetus in labour, disrupting the balance between contraction and relaxation and reducing the relative period of relaxation and recovery between contractions (Fig.  1 ).

Both increased strength and frequency of contractions, driven by synthetic oxytocin, can overwhelm the normally adequate fetal adaptations to labour hypoxia, especially for the vulnerable fetus [ 25 , 197 , 198 ].

Detailed studies using an in-vivo model in sheep have found that the fetus can withstand extreme hypoxia (intermittent umbilical cord occlusion for 1 minute) if there is sufficient time for reperfusion and recovery [ 199 , 200 ].

Clinical researchers have observed that complete post-contraction recovery of fetal heart rate and fetal oxygen saturation requires intervals of at least 2 minutes between contractions and that relatively shorter intervals increase the risk of low pH in newborn cord blood (acidaemia) [ 201 , 202 , 203 ]. Similarly, markers of fetal cerebral hypoxia in labour, which correlates with newborn acidaemia, are worsened when the interval between contractions is less than 2.3 minutes [ 204 , 205 ]. A greater degree of newborn acidaemia predicts higher morbidity, including lower APGAR scores and higher risks of respiratory morbidity and newborn intensive care unit (NICU) admission [ 206 ].

These considerations highlight the potential hazards of synthetic oxytocin for the fetus/newborn. Newborns whose mothers receive synthetic oxytocin infusions in labour, compared to newborns of women without synthetic oxytocin, have increased risks of acidaemia; NICU admission; hypoxic-ischaemic encephalopathy, a marker of brain compromise; convulsions and other indications of neurological morbidity; and in some settings, increased risks of neonatal death [ 207 , 208 , 209 , 210 , 211 , 212 ]. These risks are highlighted by the Institute for Safe Medication Practices, who nominated synthetic oxytocin as a high-alert medication that carries “a heightened risk of harm” and requires “special safeguards to reduce the risk of error” [ 213 ]. According to Clark (2009), allegations of synthetic oxytocin misuse may be involved in half of all paid obstetric litigation claims [ 214 ]. For these reasons, monitoring of fetal wellbeing, including fetal heart rate monitoring, is essential when synthetic oxytocin is administered in labour.

Newborns of women administered synthetic oxytocin in labour also have higher risks of jaundice, likely due to increased erythrocyte fragility [ 215 , 216 , 217 , 218 ]. Studies have also found that newborns of exposed women have lower levels of glutathione and markers that indicate more oxidative stress, compared to newborns of unexposed women, likely due to hypoxic effects [ 219 , 220 , 221 ].

As discussed, studies have also linked maternal exposure to synthetic oxytocin in labour with changes to newborn breastfeeding behaviours and with reduced breastfeeding success and duration in most studies [ 131 , 132 , 133 , 134 , 135 , 136 ]. Some findings suggest an earlier onset of pre-breastfeeding behaviours [ 137 ]. (See Erickson (2017) for review [ 138 ]). The mechanisms for such possible effects are not clear and may involve impacts in both mother and baby, as discussed above. Epidural analgesia may be a confounding factor for negative impacts, and induction of labour (by any method) may also impact breastfeeding, possibly by pre-empting full newborn readiness [ 138 , 222 ]. Disruptions to breastfeeding can have significant detrimental long-term impacts on offspring health and wellbeing [ 223 , 224 ].

Another possible mechanism for indirect offspring impacts is an increased risk of maternal-newborn separation due to co-interventions such as epidural and caesareans, which may also impact breastfeeding success [ 225 , 226 , 227 ].

In summary, synthetic oxytocin administration in labour makes uterine contractions stronger and more frequent, compared to physiological birth. At higher infusion rates, this can increase fetal hypoxic stresses, with well-recognised risks for the fetus and newborn. Longer-term offspring impacts are also possible.

Strengths and limitations of this review

There are strengths and limitations in the studies included in this review. This review, like all systematic reviews, can only make conclusions based on the existing publications, as identified according to the chosen research question and search terms.

It is likely that the vast majority of relevant studies would have been published in peer-reviewed journals and identified in the chosen data bases using the configured search terms. Negative publication bias is unlikely, as the data is neutral in relation to hypotheses and models. In addition, while a preponderance of older studies may seem a limitation, the older studies have generally provided the most reliable and consistent data, including the use of the gold-standard RIA assay. Some of the data in these older studies is unique and no longer obtainable, as similar studies cannot be performed today for ethical, practical and/or funding reasons.

The women included in these older studies may have some different characteristics to modern populations, who may be older or with higher BMI. However, the pharmacological responses to synthetic oxytocin, as documented here, would not be expected to vary substantially between populations. Of interest, one included study (De Tina 2019) found no difference in oxytocin levels in response to synthetic oxytocin infusions in obese vs. non-obese women [ 46 ]. Some studies have found longer labour, and longer duration of synthetic oxytocin infusions in women with higher BMI, but generally not higher infusion rates [ 228 , 229 ].

One limitation is that relatively few studies were identified, especially in some categories, making the small amount of data in these areas less robust. In addition, some studies did not clearly define dose, administration, and sample timings, and control groups were not always included.

A major strength of this review and methodology is the collating of all available numerical data on maternal and newborn oxytocin levels in response to maternal synthetic oxytocin administration. This has facilitated data-based pharmacological calculations of infusion rates, the total doses administered to labouring women and the resulting oxytocin levels. This data can then be compared with data from other clinical studies, and with levels in physiological labour. These comparisons can also inform clinicians in establishing thresholds in dosage and pharmacological effects that may exceed physiological parameters and potentially over-ride maternal and/or fetal adaptations. The infusion rates seen in this review are similar to those recommended in modern maternity-care guidelines and protocols, as discussed.

This hard data and calculations also provide important and unique perspectives on comparative dose-exposures for animal offspring. Calculations in this review show that dose-exposures in current animal studies, whether administered to the pregnant female or to the newborn, are many-fold higher than safe human exposures for the pregnant woman or her fetus/newborn. This adds important caveats to the interpretation of current animal models of synthetic oxytocin exposure, including in relation to possible long-term impacts. These considerations are also underlined by the included human data on newborn oxytocin levels, which did not rise in response to maternal synthetic oxytocin administration.

This methodology and data are also uniquely valuable in assessing the likelihood of direct biological impacts of perinatal exposure to synthetic oxytocin on the maternal brain. Again, the hard data in this review, and calculations based on this data, do not support direct maternal psychological or neurological effects from synthetic oxytocin transfer into the maternal brain in the perinatal period.

Another strength of this review is the wide cross-disciplinary authorship, providing understandings and perspectives from many fields to widen the scope for data interpretation. This includes midwives, obstetricians, clinicians, a psychiatrist, and researchers with competence in physiology and pharmacology. This breadth has allowed a deeper understanding of physiological, pharmacological and clinical implications, including other mechanisms that could contribute to maternal and/or offspring impacts from peripartum synthetic oxytocin exposure.

In addition, the detailed physiological knowledge of oxytocin analysis and assay characteristics in this paper, together with precise descriptions and understanding of dose levels and concentrations will facilitate the use of synthetic oxytocin in safe and efficient ways by clinicians, and provide basic and accurate information for researchers and other interested parties.

Clinical implications

Given the large numbers of women who receive synthetic oxytocin in the perinatal period, it is critical to understand the clinical impacts for women and their offspring. The clinicians who prescribe and administer this drug must know exactly how much they are giving, in order to optimally adapt the dosage and reduce the risks of potentially serious side-effects for women and their babies. This review adds critical information about how these dose regimens might impact maternal plasma oxytocin levels, which is essential in understanding safety in the short and longer terms.

One important finding is that infusion rates below 10 mU/min are unlikely to raise maternal plasma oxytocin levels above physiological levels. (Note that only data obtained by the well-validated, specific and sensitive RIA can be used in these types of comparisons and analysis.) Based on this data, as far as possible “… the dose of oxytocin required to establish labour in term pregnancy should be low and within the physiological range.” (Dawood 95, p587) [ 81 ].

The data in this review also aid the reader in calculating how much synthetic oxytocin is given, facilitating comparisons with other clinical studies (Table  5 ). Such comparisons are often difficult due to different dose regimes and the translation from infusion rates in mU/min to total doses in IU. Calculations of dose-exposure also help readers to judge where animal research is relevant to clinical human studies.

In relation to concerns about synthetic oxytocin crossing directly into the maternal brain or to the fetus in labour, this review found that the doses of synthetic oxytocin used in clinical practice give only moderate elevations in maternal levels, which are insufficient to cross the maternal blood-brain barrier or to cross the placenta to the fetus in biologically significant amounts. Therefore, according to the data in this review, direct biological effects from infusions of synthetic oxytocin at clinical doses are extremely unlikely for women or offspring.

However, caution is urged in the administration of synthetic oxytocin in labour, as significant indirect impacts for women and offspring are recognised. For women, the stronger and more frequent uterine contractions driven by synthetic oxytocin will generally reduce uterine blood supply to a greater extent than during physiological labour, especially at higher doses. This deficit will inevitably increase hypoxia, lactic acid and physiological stresses within uterine tissues, which could shift maternal autonomic functioning towards stress and away from the oxytocin-related parasympathetic calm and connection physiology. If these effects become sustained, this could account for associations between the use of maternal synthetic oxytocin infusions and negative impacts on breastfeeding and maternal psychological wellbeing as discussed, but has not been well-researched.

For the fetus, the stronger and more frequent contractions driven by synthetic oxytocin will compress placental blood vessels and reduce fetal blood supply more than during physiological labour, with shorter intervals for replenishment between contractions. The increased fetal hypoxic stress has well-recognised newborn risks, with plausible longer-term biological effects, as discussed.

The risks for both the woman and her baby will be determined by the infusion rate and resulting uterine activity, and the impacts on uterine blood flow. Clinically, this again emphasises the importance of using the lowest possible effective dosage of synthetic oxytocin, with the least impact on uterine physiology and blood flow. This low-dose approach may also reduce the need for co-interventions, which can add additional risks.

These low doses may also be achievable using pulsed administration, which is more aligned with endogenous oxytocin release in labour and allows time for uterine blood flow restoration between pulses. This is likely to benefit the fetus as well.

It is noteworthy that the models and conclusions presented here, derived from this systematic review data, are in alignment with the data and interpretations published from the 1960s to the 1990s by the notable research group including Fritz and Anna-Riitta Fuchs, M. Yusoff Dawood, Peter Husslein and colleagues. This group established fundamental understandings of oxytocin physiology in labour, including clinical implications. Their work remains very relevant to modern clinicians, and readers are urged to read their research and summaries in their excellent review articles and chapters [ 81 , 230 , 231 , 232 ].

Finally, authors of this review suggest that the need for synthetic oxytocin administration for labour augmentation could be reduced by supporting activation of endogenous oxytocin for labouring women. Oxytocin release is very sensitive to stressors, even very subtle stressors such as unfamiliar persons and being in an unfamiliar surroundings [ 233 ]. In contrast, touch, warmth, and friendly, supportive behaviour from caregivers can promote the progress of labour by optimising the release of oxytocin and the activity of the parasympathetic nervous system. (See Uvnäs-Moberg (2019) for further discussion [ 1 ].) Models of care that foster physiological birth, such as continuity of midwifery care and continuous support for women during childbirth, may involve optimisation of oxytocin systems [ 234 , 235 ].

This paper has focussed on plasma levels of oxytocin in response to synthetic oxytocin administration in labour, birth or postpartum. The possible impacts on the endogenous oxytocin systems of women and offspring have also been considered, since the oxytocin system is involved not only in the physical processes of labour and birth but also adapts maternal physiology and behaviour through central oxytocin effects.

This data shows that maternal plasma oxytocin levels increase moderately in response to synthetic oxytocin infusions in labour. These levels would not be high enough to cross the maternal blood-brain barrier in biologically significant amounts. Furthermore, there was no evidence of transfer of maternal oxytocin to the fetus across the placenta.

These findings strongly refute the possibility that synthetic oxytocin administered in labour could have direct biological effects on maternal or fetal central oxytocin systems.

However, indirect effects from high doses are very likely. Strengthened uterine contractions, along with reduced uterine blood flow, cause a build-up of lactic acid and low pH in uterine tissues, as described. This causes increased maternal pain and physiological stresses, which are signalled to the brain via SNS pathways that activate central stress responses. Longer-term maternal impacts from stress system activation in labour are biologically plausible. For the fetus, restricted blood flow will cause hypoxia to some extent and increase the risks of fetal compromise. Such adverse effects are more likely to occur at higher infusion rates.

Based on this review and considerations of the findings and implications, maternity care approaches that limit the use of synthetic oxytocin to situations where this intervention will clearly do more good than harm are recommended. Where there are strong clinical indicators, this data supports the most conservative use of synthetic oxytocin at the lowest possible infusion rates.

Availability of data and materials

The dataset supporting the conclusions of this review are included within the article and its additional file.

Abbreviations

Autonomic nervous system

Cumulative Index of Nursing and Allied Health Literature

Centimetres of cervical dilation

Measure of newborn wellbeing

Enzyme- linked immunosorbent assay

Enzyme-linked immunoassay

International units

Metabolic clearance rate

Micromoles per litre

Newborn intensive care unit

Nanomoles per litre

Measure of acidity

Placental leucine aminopeptidase

Picomoles per litre

Postpartum haemorrhage

Preferred Reporting Items for Systematic reviews and Meta-Analyses

Parasympathetic nervous system

Paraventricular nucleus

Receptor for advanced glycation end- products

Radioimmunoassay

Skin-to-skin contact

Sympathetic nervous system

Supraoptic nucleus

• Synthetic oxytocin

Umbilical artery

Umbilical vein

(See also Table 3 for SI units and oxytocin conversion)

Uvnäs-Moberg K, Ekström-Bergström A, Berg M, Buckley S, Pajalic Z, Hadjigeorgiou E, et al. Maternal plasma levels of oxytocin during physiological childbirth - a systematic review with implications for uterine contractions and central actions of oxytocin. BMC Pregnancy Childbirth. 2019;19(1):285.

Article   PubMed   PubMed Central   Google Scholar  

Uvnäs Moberg K, Ekström-Bergström A, Buckley S, Massarotti C, Pajalic Z, Luegmair K, et al. Maternal plasma levels of oxytocin during breastfeeding-a systematic review. PLoS One. 2020;15(8):e0235806.

Sofroniew MV. Morphology of vasopressin and oxytocin neurones and their central and vascular projections. Prog Brain Res. 1983;60:101–14.

Article   CAS   PubMed   Google Scholar  

Uvnas-Moberg K. Oxytocin: the biological guide to motherhood. Amarillo: Praeclarus Press; 2016.

Google Scholar  

Fuchs AR, Romero R, Keefe D, Parra M, Oyarzun E, Behnke E. Oxytocin secretion and human parturition: pulse frequency and duration increase during spontaneous labor in women. Am J Obstet Gynecol. 1991;165(5 Pt 1):1515–23.

Wakerley JB, Terenzi MG, Housham SJ, Jiang QB, Ingram CD. Electrophysiological effects of oxytocin within the bed nuclei of the stria terminalis: influence of reproductive stage and ovarian steroids. Prog Brain Res. 1998;119:321–34.

Fuchs AR, Fuchs F, Husslein P, Soloff MS, Fernstrom MJ. Oxytocin receptors and human parturition: a dual role for oxytocin in the initiation of labor. Science. 1982;215(4538):1396–8.

Gimpl G, Fahrenholz F. The oxytocin receptor system: structure, function, and regulation. Physiol Rev. 2001;81(2):629–83.

Mitchell BF, Schmid B. Oxytocin and its receptor in the process of parturition. J Soc Gynecol Investig. 2001;8(3):122–33.

Nishimori K, Young LJ, Guo Q, Wang Z, Insel TR, Matzuk MM. Oxytocin is required for nursing but is not essential for parturition or reproductive behavior. Proc Natl Acad Sci U S A. 1996;93(21):11699–704.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Young WS 3rd, Shepard E, Amico J, Hennighausen L, Wagner KU, LaMarca ME, et al. Deficiency in mouse oxytocin prevents milk ejection, but not fertility or parturition. J Neuroendocrinol. 1996;8(11):847–53.

Papka RE, McCurdy JR, Williams SJ, Mayer B, Marson L, Platt KB. Parasympathetic preganglionic neurons in the spinal cord involved in uterine innervation are cholinergic and nitric oxide-containing. Anat Rec. 1995;241(4):554–62.

Benoussaidh A, Maurin Y, Rampin O. Spinal effects of oxytocin on uterine motility in anesthetized rats. Am J Phys Regul Integr Comp Phys. 2004;287(2):R446–53.

CAS   Google Scholar  

Sato Y, Hotta H, Nakayama H, Suzuki H. Sympathetic and parasympathetic regulation of the uterine blood flow and contraction in the rat. J Auton Nerv Syst. 1996;59(3):151–8.

Article   PubMed   Google Scholar  

Burbach JPH, Young LJ,  Russell JA. Oxytocin: Synthesis, Secretion, and Reproductive Functions. In: Neill JD, editor. Knobil and Neill’s Physiology of Reproduction. 3rd edn. 2006. p. 3055–128.

Ferguson JK. A study of the motility of the intact uterus at term. Surg Gynecol Obstet. 1941;73:359–66.

Wiberg-Itzel E. Amniotic fluid lactate (AFL): a new predictor of labor outcome in dystocic deliveries. J Matern Fetal Neonatal Med. 2021;35(25):7306–11.

Wray S. Uterine contraction and physiological mechanisms of modulation. Am J Phys. 1993;264(1 Pt 1):C1–18.

Wray S. Insights from physiology into myometrial function and dysfunction. Exp Physiol. 2015;100(12):1468–76.

Arai T. The significance of plasma oxytocin in pregnancy and at parturition. Acta Obstet Gynaecol Jpn. 1980;32(12):2017–26.

CAS   PubMed   Google Scholar  

Olza I, Uvnas-Moberg K, Ekström-Bergström A, Leahy-Warren P, Karlsdottir SI, Nieuwenhuijze M, et al. Birth as a neuro-psycho-social event: an integrative model of maternal experiences and their relation to neurohormonal events during childbirth. PLoS One. 2020;15(7):e0230992.

Marchini G, Lagercrantz H, Winberg J, Uvnas-Moberg K. Fetal and maternal plasma levels of gastrin, somatostatin and oxytocin after vaginal delivery and elective cesarean section. Early Hum Dev. 1988;18(1):73–9.

Zinni M, Colella M, Batista Novais AR, Baud O, Mairesse J. Modulating the oxytocin system during the perinatal period: a new strategy for neuroprotection of the immature brain? Front Neurol. 2018;9:229.

Boll S, Almeida de Minas AC, Raftogianni A, Herpertz SC, Grinevich V. Oxytocin and pain perception: from animal models to human research. Neuroscience. 2018;387:149–61.

Lagercrantz H. The good stress of being born. Acta Paediatr. 2016;105(12):1413–6.

Lagercrantz H, Bistoletti P. Catecholamine release in the newborn infant at birth. Pediatr Res. 1977;11(8):889–93.

Bistoletti P, Lagercrantz H, Lunell NO. Fetal plasma catecholamine concentrations and fetal heart-rate variability during first stage of labour. Br J Obstet Gynaecol. 1983;90(1):11–5.

Lagercrantz H, Peyronnet J, Yuan SZ, Tang LQ. Catecholamines, hypoxic defence and the neonatal brain. Dev Med Child Neurol Suppl. 2001;86:28–9.

JHP Pharmaceuticals. Pitocin (package insert) 9; 2022.

Aye CY, Redman CW, Georgieva A. The effect of augmentation of labour with syntocinon on the fetal CTG using objective computerised analysis: a nested case-control study. Eur J Obstet Gynecol Reprod Biol. 2014;176:112–8.

Caldeyro-Barcia R, Sica-Blanco Y, Poseiro JJ, Gonzalez Panizza V, Mendez-Bauer C, Fielitz C, et al. A quantitative study of the action of synthetic oxytocin on the pregnant human uterus. J Pharmacol Exp Ther. 1957;121(1):18–31.

Lovold A, Stanton C, Armbruster D. How to avoid iatrogenic morbidity and mortality while increasing availability of oxytocin and misoprostol for PPH prevention? Int J Gynaecol Obstet. 2008;103(3):276–82.

Seijmonsbergen-Schermers AE, van den Akker T, Rydahl E, Beeckman K, Bogaerts A, Binfa L, et al. Variations in use of childbirth interventions in 13 high-income countries: a multinational cross-sectional study. PLoS Med. 2020;17(5):e1003103.

Kujabi ML, Mikkelsen E, Housseine N, Obel J, SequeiraD'Mello B, Meyrowitsch DW, et al. Labor augmentation with oxytocin in low- and lower-middle-income countries: a systematic review and meta-analysis. AJOG Global Reports. 2022:2(4):1–13.

World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: World Health Organization; 2012.

World Health Organization. WHO recommendation on routes of oxytocin administration for the prevention of postpartum haemorrhage after vaginal birth. In . , Licence: CC BY-NC-SA 3.0 IGO edn. Geneva: World Health Organization; 2020.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

McCullough ME, Churchland PS, Mendez AJ. Problems with measuring peripheral oxytocin: can the data on oxytocin and human behavior be trusted? Neurosci Biobehav Rev. 2013;37(8):1485–92.

Quintana DS, Westlye LT, Smerud KT, Mahmoud RA, Andreassen OA, Djupesland PG. Saliva oxytocin measures do not reflect peripheral plasma concentrations after intranasal oxytocin administration in men. Horm Behav. 2018;102:85–92.

Schaebs FS, Wirobski G, Marshall-Pescini S, Range F, Deschner T. Validation of a commercial enzyme immunoassay to assess urinary oxytocin in humans. Endocr Connect. 2021;10(3):290–301.

White-Traut R, Watanabe K, Pournajafi-Nazarloo H, Schwertz D, Bell A, Carter CS. Detection of salivary oxytocin levels in lactating women. Dev Psychobiol. 2009;51(4):367–73.

Amico JA, Seitchik J, Robinson AG. Studies of oxytocin in plasma of women during hypocontractile labor. J Clin Endocrinol Metab. 1984;58(2):274–9.

Amico JA, Ervin MG, Finn FM, Leake RD, Fisher DA, Robinson AG. The plasma of pregnant women contains a novel oxytocin-vasotocin-like peptide. Metabolism. 1986;35(7):596–601.

Dawood MY, Wang CF, Gupta R, Fuchs F. Fetal contribution to oxytocin in human labor. Obstet Gynecol. 1978;52(2):205–9.

Dawood MY, Ylikorkala O, Fuchs F. Plasma oxytocin levels and disappearance rate after buccal Pitocin. Am J Obstet Gynecol. 1980;138(1):20–4.

De Tina A, Juang J, McElrath TF, Baty JD, Palanisamy A. Oxytocin and Oxytocinase in the obese and nonobese Parturients during induction and augmentation of labor. AJP Rep. 2019;9(2):e177–e84.

Ende HB, Soens MA, Nandi M, Strichartz GR, Schreiber KL. Association of Interindividual Variation in plasma oxytocin with Postcesarean incisional pain. Anesth Analg. 2019;129(4):e118–e21.

Erickson EN, Carter CS, Emeis CL. Oxytocin, vasopressin and prolactin in new breastfeeding mothers: relationship to clinical characteristics and infant weight loss. J Hum Lact. 2020;36(1):136–45.

Fuchs AR, Husslein P, Sumulong L, Fuchs F. The origin of circulating 13,14-dihydro-15-keto-prostaglandin F2 alpha during delivery. Prostaglandins. 1982;24(5):715–22.

Fuchs AR, Goeschen K, Husslein P, Rasmussen AB, Fuchs F. Oxytocin and initiation of human parturition. III. Plasma concentrations of oxytocin and 13,14-dihydro-15-keto-prostaglandin F2 alpha in spontaneous and oxytocin-induced labor at term. Am J Obstet Gynecol. 1983;147(5):497–502.

Furuya K, Nagata I, Imaizumi E, Hirata J, Kato K. Fundamental studies on the measurement of plasma concentration of oxytocin during perinatal period. Nihon Sanka Fujinka Gakkai Zasshi. 1988;40(11):1685–92.

Gibbens D, Boyd NR, Crocker S, Baumber S, Chard T. The circulating levels of oxytocin following intravenous and intramuscular administration of Syntometrine. J Obstet Gynaecol Br Commonw. 1972;79(7):644–6.

Gu V, Feeley N, Gold I, Hayton B, Robins S, Mackinnon A, et al. Intrapartum synthetic oxytocin and its effects on maternal well-being at 2 months postpartum. Birth. 2016;43(1):28–35.

Handlin L, Jonas W, Petersson M, Ejdeback M, Ransjo-Arvidson AB, Nissen E, et al. Effects of sucking and skin-to-skin contact on maternal ACTH and cortisol levels during the second day postpartum-influence of epidural analgesia and oxytocin in the perinatal period. Breastfeed Med. 2009;4(4):207–20.

Husslein P, Fuchs AR, Fuchs F. Oxytocin- and prostaglandin plasma concentrations before and after spontaneous labor: evidence of involvement of prostaglandins in the mechanism of placental separation. Wien Klin Wochenschr. 1983;95(11):367–71.

Husslein P, Kofler E, Rasmussen AB, Sumulong L, Fuchs AR, Fuchs F. Oxytocin and the initiation of human parturition. IV. Plasma concentrations of oxytocin and 13,14-dihydro-15-keto-prostaglandin F2 alpha during induction of labor by artificial rupture of the membranes. Am J Obstet Gynecol. 1983;147(5):503–7.

Jonas W, Johansson LM, Nissen E, Ejdebäck M, Ransjö-Arvidson AB, Uvnäs-Moberg K. Effects of intrapartum oxytocin administration and epidural analgesia on the concentration of plasma oxytocin and prolactin, in response to suckling during the second day postpartum. Breastfeed Med. 2009;4(2):71–82.

Otsuki Y, Tanizawa O, Yamaji K, Fujita M, Kurachi K. Feto-maternal plasma oxytocin levels in normal and anencephalic pregnancies. Acta Obstet Gynecol Scand. 1983;62(3):235–7.

Padayachi T, Norman RJ, Dhavaraj K, Kemp M, Joubert SM. Serial oxytocin levels in amniotic fluid and maternal plasma during normal and induced labour. Br J Obstet Gynaecol. 1988;95(9):888–93.

Patient C, Davison JM, Charlton L, Baylis PH, Thornton S. The effect of labour and maternal oxytocin infusion on fetal plasma oxytocin concentration. Br J Obstet Gynaecol. 1999;106(12):1311–3.

Perry RL, Satin AJ, Barth WH, Valtier S, Cody JT, Hankins GD. The pharmacokinetics of oxytocin as they apply to labor induction. Am J Obstet Gynecol. 1996;174(5):1590–3.

Pochard JL, Lutz-Bucher B. Vasopressin and oxytocin levels in human neonates. Relationships with the evolution of labour and beta-endorphins. Acta Paediatr Scand. 1986;75(5):774–8.

Prevost M, Zelkowitz P, Tulandi T, Hayton B, Feeley N, Carter CS, et al. Oxytocin in pregnancy and the postpartum: relations to labor and its management. Front Public Health. 2014;2:1.

Risberg A, Sjoquist M, Wedenberg K, Olsson U, Larsson A. Water balance during parturition and early puerperium: a prospective open trial. Clin Biochem. 2015;48(13–14):837–42.

Seitchik J, Amico J, Robinson AG, Castillo M. Oxytocin augmentation of dysfunctional labor. IV. Oxytocin pharmacokinetics. Am J Obstet Gynecol. 1984;150(3):225–8.

Seitchik J, Amico JA, Castillo M. Oxytocin augmentation of dysfunctional labor. V. an alternative oxytocin regimen. Am J Obstet Gynecol. 1985;151(6):757–61.

Sellers SM, Hodgson HT, Mountford LA, Mitchell MD, Anderson AB, Turnbull AC. Is oxytocin involved in parturition? Br J Obstet Gynaecol. 1981;88(7):725–9.

Takahashi Y, Uvnäs-Moberg K, Nissen E, Lidfors L, Ransjö-Arvidson AB, Jonas W. Epidural analgesia with or without oxytocin, but not oxytocin alone, administered during birth disturbs infant pre-feeding and sucking behaviors and maternal oxytocin levels in connection with a breastfeed two days later. Front Neurosci. 2021;15:673184.

Thornton S, Davison JM, Baylis PH. Plasma oxytocin during third stage of labour: comparison of natural and active management. Br Med J. 1988;297(6642):167–9.

Article   CAS   Google Scholar  

Thornton S, Davison JM, Baylis PH. Effect of human pregnancy on metabolic clearance rate of oxytocin. Am J Phys. 1990;259(1 Pt 2):R21–4.

Thornton S, Davison JM, Baylis PH. Plasma oxytocin during the first and second stages of spontaneous human labour. Acta Endocrinol. 1992;126(5):425–9.

Velandia M. Parent-infant skin-to-skin contact studies. PhD. Stockholm: Karolinska Institutet; 2012.

Yamaguchi ET, Cardoso MM, Torres ML, Nascimento RC, Ribeiro MC, Frerichs E, et al. Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens. Int J Obstet Anesth. 2011;20(3):224–8.

Yuksel B, Ital I, Balaban O, Kocak E, Seven A, Kucur SK, et al. Immediate breastfeeding and skin-to-skin contact during cesarean section decreases maternal oxidative stress, a prospective randomized case-controlled study. J Matern Fetal Neonatal Med. 2016;29(16):2691–6.

Leng G, Sabatier N. Measuring oxytocin and vasopressin: bioassays, immunoassays and random numbers. J Neuroendocrinol. 2016;28:1–13.

Uvnäs Moberg K, Handlin L, Kendall-Tackett K, Petersson M. Oxytocin is a principal hormone that exerts part of its effects by active fragments. Med Hypotheses. 2019;133:109394.

Rahm VA, Hallgren A, Hogberg H, Hurtig I, Odlind V. Plasma oxytocin levels in women during labor with or without epidural analgesia: a prospective study. Acta Obstet Gynecol Scand. 2002;81(11):1033–9.

Daly D, Minnie KCS, Blignaut A, Blix E, Vika Nilsen AB, Dencker A, et al. How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries. PLoS One. 2020;15(7):e0227941.

Rydén G, Sjöholm I. Half-life of oxytoxin in blood of pregnant and non-pregnant woman. Acta Obstet Gynecol Scand. 1969;48(S3):139–40.

Saameli K. An indirect method for the estimation of oxytocin blood concentration and half-life in pregnant women near term. Am J Obstet Gynecol. 1963;85:186–92.

Dawood MY. Novel approach to oxytocin induction-augmentation of labor. Application of oxytocin physiology during pregnancy. Adv Exp Med Biol. 1995;395:585–94.

Legros JJ, Chiodera P, Geenen V, Smitz S, von Frenckell R. Dose-response relationship between plasma oxytocin and cortisol and adrenocorticotropin concentrations during oxytocin infusion in normal men. J Clin Endocrinol Metab. 1984;58(1):105–9.

Nielsen EI, Al-Saqi SH, Jonasson AF, Uvnas-Moberg K. Population pharmacokinetic analysis of vaginally and intravenously administered oxytocin in postmenopausal women. J Clin Pharmacol. 2017;57(12):1573–81.

Yamahara N, Nomura S, Suzuki T, Itakura A, Ito M, Okamoto T, et al. Placental leucine aminopeptidase/oxytocinase in maternal serum and placenta during normal pregnancy. Life Sci. 2000;66(15):1401–10.

Leake RD, Weitzman RE, Fisher DA. Pharmacokinetics of oxytocin in the human subject. Obstet Gynecol. 1980;56(6):701–4.

Mylan Products. Syntocinon 10 IU/ml concentrate for solution for infusion; 2021. https://www.medicines.org.uk/emc/product/9735/smpc . Accessed 3 Nov 2022

Simpson KR. Clinicians' guide to the use of oxytocin for labor induction and augmentation. J Midwifery Womens Health. 2011;56(3):214–21.

Arias F. Pharmacology of oxytocin and prostaglandins. Clin Obstet Gynecol. 2000;43(3):455–68.

Gonser M. Labor induction and augmentation with oxytocin: pharmacokinetic considerations. Arch Gynecol Obstet. 1995;256(2):63–6.

Sundin C, Mazac L, Ellis K, Garbo C. Implementation of an oxytocin checklist to improve clinical outcomes. MCN Am J Matern Child Nurs. 2018;43(3):133–8.

Cummiskey KC, Dawood MY. Induction of labor with pulsatile oxytocin. Am J Obstet Gynecol. 1990;163(6 Pt 1):1868–74.

Cummiskey KC, Gall SA, Dawood MY. Pulsatile administration of oxytocin for augmentation of labor. Obstet Gynecol. 1989;74(6):869–72.

Odem RR, Work BA Jr, Dawood MY. Pulsatile oxytocin for induction of labor: a randomized prospective controlled study. J Perinat Med. 1988;16(1):31–7.

Randolph GW, Fuchs AR. Pulsatile administration enhances the effect and reduces the dose of oxytocin required for induction of labor. Am J Perinatol. 1989;6(2):159–66.

Tribe RM, Crawshaw SE, Seed P, Shennan AH, Baker PN. Pulsatile versus continuous administration of oxytocin for induction and augmentation of labor: two randomized controlled trials. Am J Obstet Gynecol. 2012;206(3):230.e1–8.

Ilicic M, Zakar T, Paul JW. The regulation of uterine function during parturition: an update and recent advances. Reprod Sci. 2020;27(1):3–28.

Kofler E, Husslein P, Langer M, Fuchs AR, Fuchs F. Importance of oxytocin sensitivity for the spontaneous onset of human labor. Geburtshilfe Frauenheilkd. 1983;43(9):533–7.

Yulia A, Johnson MR. Myometrial oxytocin receptor expression and intracellular pathways. Minerva Ginecol. 2014;66(3):267–80.

Sheibani L, Wing DA. A safety review of medications used for labour induction. Expert Opin Drug Saf. 2018;17(2):161–7.

Oladapo OT, Okusanya BO, Abalos E, Gallos ID, Papadopoulou A. Intravenous versus intramuscular prophylactic oxytocin for the third stage of labour. Cochrane Database Syst Rev. 2020;11(11):Cd009332.

PubMed   Google Scholar  

Zhou YH, Xie Y, Luo YZ, Liu XW, Zhou J, Liu Q. Intramuscular versus intravenous oxytocin for the third stage of labor after vaginal delivery to prevent postpartum hemorrhage: a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2020;250:265–71.

Pinder AJ, Dresner M, Calow C, Shorten GD, O'Riordan J, Johnson R. Haemodynamic changes caused by oxytocin during caesarean section under spinal anaesthesia. Int J Obstet Anesth. 2002;11(3):156–9.

Thomas JS, Koh SH, Cooper GM. Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing caesarean section. Br J Anaesth. 2007;98(1):116–9.

Svanström MC, Biber B, Hanes M, Johansson G, Näslund U, Bålfors EM. Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during caesarean section. Br J Anaesth. 2008;100(5):683–9.

Archer TL, Knape K, Liles D, Wheeler AS, Carter B. The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery: findings in six cases. Int J Obstet Anesth. 2008;17(3):247–54.

Jonsson M, Hanson U, Lidell C, Norden-Lindeberg S. ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial. BJOG. 2010;117(1):76–83.

Bekkenes ME, Fagerland MW, Solberg OG, Aaberge L, Klingenberg O, Norseth J, et al. Exploring cardiac effects after oxytocin 2.5 IU or carbetocin 100 μg: a randomised controlled trial in women undergoing planned caesarean delivery. Eur J Anaesthesiol. 2022;39(12):928–38.

Grinevich V, Desarmenien MG, Chini B, Tauber M, Muscatelli F. Ontogenesis of oxytocin pathways in the mammalian brain: late maturation and psychosocial disorders. Front Neuroanat. 2014;8:164.

Burford GD, Robinson IC. Oxytocin, vasopressin and neurophysins in the hypothalamo-neurohypophysial system of the human fetus. J Endocrinol. 1982;95(3):403–8.

Schubert F, George JM, Rao MB. Vasopressin and oxytocin content of human fetal brain at different stages of gestation. Brain Res. 1981;213(1):111–7.

Hammock EA. Developmental perspectives on oxytocin and vasopressin. Neuropsychopharmacology. 2015;40(1):24–42.

Mathur VS, Walker JM. The origin of human placental oxytocinase. J Physiol. 1970;208(2):291–8.

Nathan NO, Hedegaard M, Karlsson G, Knudsen LE, Mathiesen L. Intrapartum transfer of oxytocin across the human placenta: an ex vivo perfusion experiment. Placenta. 2021;112:105–10.

Jones PM, Robinson IC. Differential clearance of neurophysin and neurohypophysial peptides from the cerebrospinal fluid in conscious Guinea pigs. Neuroendocrinology. 1982;34(4):297–302.

Ermisch A, Rühle HJ, Landgraf R, Hess J. Blood-brain barrier and peptides. J Cereb Blood Flow Metab. 1985;5(3):350–7.

Mens WB, Witter A, van Wimersma Greidanus TB. Penetration of neurohypophyseal hormones from plasma into cerebrospinal fluid (CSF): half-times of disappearance of these neuropeptides from CSF. Brain Res. 1983;262(1):143–9.

Nomura S, Ito T, Yamamoto E, Sumigama S, Iwase A, Okada M, et al. Gene regulation and physiological function of placental leucine aminopeptidase/oxytocinase during pregnancy. Biochim Biophys Acta. 2005;1751(1):19–25.

Malek A, Blann E, Mattison DR. Human placental transport of oxytocin. J Matern Fetal Med. 1996;5(5):245–55.

Glatz TH, Weitzman RE, Nathanielsz PW, Fisher DA. Metabolic clearance rate and transplacental passage of oxytocin in the pregnant ewe and fetus. Endocrinology. 1980;106(3):1006–11.

Kenkel WM, Perkeybile AM, Yee JR, Pournajafi-Nazarloo H, Lillard TS, Ferguson EF, et al. Behavioral and epigenetic consequences of oxytocin treatment at birth. Sci Adv. 2019;5(5):2244.

Article   Google Scholar  

Miller TV, Caldwell HK. Oxytocin during development: possible organizational effects on behavior. Front Endocrinol (Lausanne). 2015;6(76):1–10.

Sohlström A, Carlsson-Skwirut C, Bang P, Brismar K, Uvnäs-Moberg K. Effects of oxytocin treatment early in pregnancy on fetal growth in ad libitum-fed and food-restricted rats. Pediatr Res. 1999;46(3):339–44.

Sohlstrom A, Olausson H, Brismar K, Uvnas-Moberg K. Oxytocin treatment during early life influences reproductive performance in ad libitum fed and food-restricted female rats. Biol Neonate. 2002;81(2):132–8.

Uvnas-Moberg K, Alster P, Petersson M, Sohlstrom A, Bjorkstrand E. Postnatal oxytocin injections cause sustained weight gain and increased nociceptive thresholds in male and female rats. Pediatr Res. 1998;43(3):344–8.

Bell AF, Erickson EN, Carter CS. Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood. J Midwifery Womens Health. 2014;59(1):35–42.

Monks DT, Palanisamy A. Oxytocin: at birth and beyond. A systematic review of the long-term effects of peripartum oxytocin. Anaesthesia. 2021;76:1526–37.

Lee MR, Shnitko TA, Blue SW, Kaucher AV, Winchell AJ, Erikson DW, et al. Labeled oxytocin administered via the intranasal route reaches the brain in rhesus macaques. Nat Commun. 2020;11(1):2783.

Higashida H, Furuhara K, Lopatina O, Gerasimenko M, Hori O, Hattori T, et al. Oxytocin dynamics in the body and brain regulated by the receptor for advanced glycation end-products, CD38, CD157, and nicotinamide riboside. Front Neurosci. 2022;16:858070.

Yamamoto Y, Liang M, Munesue S, Deguchi K, Harashima A, Furuhara K, et al. Vascular RAGE transports oxytocin into the brain to elicit its maternal bonding behaviour in mice. Commun Biol. 2019;2:76.

Uvnäs-Moberg K, Gross MM, Agius A, Downe S, Calleja-Agius J. Are there epigenetic oxytocin-mediated effects on the mother and infant during physiological childbirth? Int J Mol Sci. 2020;21(24):1–13.

Bell AF, White-Traut R, Rankin K. Fetal exposure to synthetic oxytocin and the relationship with prefeeding cues within one hour postbirth. Early Hum Dev. 2013;89(3):137–43.

Garcia-Fortea P, Gonzalez-Mesa E, Blasco M, Cazorla O, Delgado-Rios M, Gonzalez-Valenzuela MJ. Oxytocin administered during labor and breast-feeding: a retrospective cohort study. J Matern Fetal Neonatal Med. 2014;27(15):1598–603.

Marin Gabriel MA, Olza Fernandez I, Malalana Martinez AM, Gonzalez Armengod C, Costarelli V, Millan Santos I, et al. Intrapartum synthetic oxytocin reduce the expression of primitive reflexes associated with breastfeeding. Breastfeed Med. 2015;10(4):209–13.

Olza Fernández I, Marín Gabriel M, Malalana Martínez A, Fernández-Cañadas Morillo A, López Sánchez F, Costarelli V. Newborn feeding behaviour depressed by intrapartum oxytocin: a pilot study. Acta Paediatr. 2012;101(7):749–54.

Liu L, Rekawek P, Cadet J, Monro J, Naert M, Stone J. Exogenous oxytocin for labor induction or augmentation is associated with a decrease in breastfeeding success. Am J Obstet Gynecol. 2020;222(1):S544.

Zhou Y, Liu W, Xu Y, Zhang X, Miao Y, Wang A, et al. Effects of different doses of synthetic oxytocin on neonatal instinctive behaviors and breastfeeding. Sci Rep. 2022;12(1):16434.

Brimdyr K, Cadwell K, Widstrom AM, Svensson K, Neumann M, Hart EA, et al. The association between common labor drugs and suckling when skin-to-skin during the first hour after birth. Birth. 2015;42(4):319–28.

Erickson EN, Emeis CL. Breastfeeding outcomes after oxytocin use during childbirth: an integrative review. J Midwifery Womens Health. 2017;62(4):397–417.

Takacs L, Seidlerova JM, Sterbova Z, Cepicky P, Havlicek J. The effects of intrapartum synthetic oxytocin on maternal postpartum mood: findings from a prospective observational study. Arch Womens Ment Health. 2019;22(4):485–91.

Kroll-Desrosiers AR, Nephew BC, Babb JA, Guilarte-Walker Y, Moore Simas TA, Deligiannidis KM. Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year. Depress Anxiety. 2017;34(2):137–46.

Thul TA, Corwin EJ, Carlson NS, Brennan PA, Young LJ. Oxytocin and postpartum depression: a systematic review. Psychoneuroendocrinology. 2020;120:104793.

Kendall-Tackett K, Uvnas MK. Does synthetic oxytocin lower mothers’ risk of postpartum depression and anxiety? A review of a recent study by Kroll-Desrosiers et al; 2017. https://www.lamaze.org/Connecting-the-Dots/does-synthetic-oxytocin-lower-mothers-risk-of-postpartum-depression-and-anxiety-a-review-of-a-recent-study-by-kroll-desrosiers-et-al . Accessed Nov 3 2022

Jonas W, Nissen E, Ransjo-Arvidson AB, Matthiesen AS, Uvnas-Moberg K. Influence of oxytocin or epidural analgesia on personality profile in breastfeeding women: a comparative study. Arch Womens Ment Health. 2008;11(5–6):335–45.

Wiberg-Itzel E, Uvnas MK. The correlation between synthetic oxytocin given during labor and Women’s personality traits according to the SSP (Swedish University scales of personality) survey: a pilot study. Open J Obstetr Gynecol. 2021;11(6):701–12.

Ito E, Shima R, Yoshioka T. A novel role of oxytocin: oxytocin-induced well-being in humans. Biophys Physicobiol. 2019;16:132–9.

Uvnäs Moberg K, Handlin L, Petersson M. Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact - with a particular focus on the oxytocinergic system. Infant Behav Dev. 2020;61:101482.

Masuzawa Y, Yaeko K. Uterine activity during the two hours after placental delivery among low-risk pregnancies: an observational study. J Matern Fetal Neonatal Med. 2017;30(20):2446–51.

Hendricks CH. Uterine contractility changes in the early puerperium. Clin Obstet Gynecol. 1968;11(1):125–44.

Begley CM. The effect of ergometrine on breast feeding (author reply). Midwifery. 1990;6(4):231–2.

LactMed. Methylergonovine. Drugs and lactation database (LactMed). Bethesda: National Library of Medicine (US); 2006.

Espada-Trespalacios X, Ojeda F, Nebot Rodrigo N, Rodriguez-Biosca A, Rodriguez Coll P, Martin-Arribas A, et al. Induction of labour as compared with spontaneous labour in low-risk women: a multicenter study in Catalonia. Sex Reprod Healthc. 2021;29:100648.

Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5:Cd000331.

Scull TJ, Hemmings GT, Carli F, Weeks SK, Mazza L, Zingg HH. Epidural analgesia in early labour blocks the stress response but uterine contractions remain unchanged. Can J Anaesth. 1998;45(7):626–30.

Behrens O, Goeschen K, Luck HJ, Fuchs AR. Effects of lumbar epidural analgesia on prostaglandin F2 alpha release and oxytocin secretion during labor. Prostaglandins. 1993;45(3):285–96.

Goodfellow CF, Hull MG, Swaab DF, Dogterom J, Buijs RM. Oxytocin deficiency at delivery with epidural analgesia. Br J Obstet Gynaecol. 1983;90(3):214–9.

Kjerulff KH, Attanasio LB, Sznajder KK, Brubaker LH. A prospective cohort study of post-traumatic stress disorder and maternal-infant bonding after first childbirth. J Psychosom Res. 2021;144:110424.

Youn H, Lee S, Han SW, Kim LY, Lee TS, Oh MJ, et al. Obstetric risk factors for depression during the postpartum period in South Korea: a nationwide study. J Psychosom Res. 2017;102:15–20.

Ponti L, Ghinassi S, Tani F. Spontaneous and induced labor: association with maternal well-being three months after childbirth. Psychol Health Med. 2021;27(4):896–901.

Hayes UL, De Vries GJ. Role of pregnancy and parturition in induction of maternal behavior in prairie voles (Microtus ochrogaster). Horm Behav. 2007;51(2):265–72.

Dahlen HG, Thornton C, Downe S, de Jonge A, Seijmonsbergen-Schermers A, Tracy S, et al. Intrapartum interventions and outcomes for women and children following induction of labour at term in uncomplicated pregnancies: a 16-year population-based linked data study. BMJ Open. 2021;11(6):e047040.

Dhamrait GK, Christian H, O'Donnell M, Pereira G. Gestational age and child development at school entry. Sci Rep. 2021;11(1):14522.

Gleason JL, Gilman SE, Sundaram R, Yeung E, Putnick DL, Vafai Y, et al. Gestational age at term delivery and children's neurocognitive development. Int J Epidemiol. 2022;50(6):1814–23.

Hanly M, Falster K, Chambers G, Lynch J, Banks E, Homaira N, et al. Gestational age and child development at age five in a population-based cohort of Australian Aboriginal and non-Aboriginal children. Paediatr Perinat Epidemiol. 2018;32(1):114–25.

Hedges A, Corman H, Noonan K, Reichman NE. Gestational age at term and educational outcomes at age nine. Pediatrics. 2021;148(2):1–11.

Ou X, Glasier CM, Ramakrishnaiah RH, Kanfi A, Rowell AC, Pivik RT, et al. Gestational age at birth and brain White matter development in term-born infants and children. AJNR Am J Neuroradiol. 2017;38(12):2373–9.

Searle AK, Smithers LG, Chittleborough CR, Gregory TA, Lynch JW. Gestational age and school achievement: a population study. Arch Dis Child Fetal Neonatal Ed. 2017;102(5):F409–f16.

Smithers LG, Searle AK, Chittleborough CR, Scheil W, Brinkman SA, Lynch JW. A whole-of-population study of term and post-term gestational age at birth and children's development. Bjog. 2015;122(10):1303–11.

Crall HD, Mattison DR. Oxytocin pharmacodynamics: effect of long infusions on uterine activity. Gynecol Obstet Investig. 1991;31(1):17–22.

Belghiti J, Kayem G, Dupont C, Rudigoz RC, Bouvier-Colle MH, Deneux-Tharaux C. Oxytocin during labour and risk of severe postpartum haemorrhage: a population-based, cohort-nested case-control study. BMJ Open. 2011;1(2):e000514.

Davey MA, Flood M, Pollock W, Cullinane F, McDonald S. Risk factors for severe postpartum haemorrhage: a population-based retrospective cohort study. Aust N Z J Obstet Gynaecol. 2020;60(4):522–32.

Erickson EN, Carlson NS. Predicting postpartum hemorrhage after low-risk vaginal birth by labor characteristics and oxytocin administration. J Obstet Gynecol Neonatal Nurs. 2020;49(6):549–63.

Khireddine I, Le Ray C, Dupont C, Rudigoz RC, Bouvier-Colle MH, Deneux-Tharaux C. Induction of labor and risk of postpartum hemorrhage in low risk parturients. PLoS One. 2013;8(1):e54858.

Grotegut CA, Paglia MJ, Johnson LN, Thames B, James AH. Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. Am J Obstet Gynecol. 2011;204(1):56 e1.

Phaneuf S, Rodriguez Linares B, TambyRaja RL, MacKenzie IZ, Lopez BA. Loss of myometrial oxytocin receptors during oxytocin-induced and oxytocin-augmented labour. J Reprod Fertil. 2000;120(1):91–7.

Robinson C, Schumann R, Zhang P, Young RC. Oxytocin-induced desensitization of the oxytocin receptor. Am J Obstet Gynecol. 2003;188(2):497–502.

Phaneuf S, Asboth G, Carrasco MP, Europe-Finner GN, Saji F, Kimura T, et al. The desensitization of oxytocin receptors in human myometrial cells is accompanied by down-regulation of oxytocin receptor messenger RNA. J Endocrinol. 1997;154(1):7–18.

Phaneuf S, Asbóth G, Carrasco MP, Liñares BR, Kimura T, Harris A, et al. Desensitization of oxytocin receptors in human myometrium. Hum Reprod Update. 1998;4(5):625–33.

Balki M, Erik-Soussi M, Kingdom J, Carvalho JC. Oxytocin pretreatment attenuates oxytocin-induced contractions in human myometrium in vitro. Anesthesiology. 2013;119(3):552–61.

Wiberg-Itzel E, Wray S, Akerud H. A randomized controlled trial of a new treatment for labor dystocia. J Matern Fetal Neonatal Med. 2018;31(17):2237–44.

Bashirian S, Seyedi M, Razjouyan K, Jenabi E. The association between labor induction and autism spectrum disorders among children: a meta-analysis. Curr. Pediatr Rev. 2021;17(3):238–43.

Fein D, Allen D, Dunn M, Feinstein C, Green L, Morris R, et al. Pitocin induction and autism. Am J Psychiatry. 1997;154(3):438–9.

Glasson EJ, Bower C, Petterson B, de Klerk N, Chaney G, Hallmayer JF. Perinatal factors and the development of autism: a population study. Arch Gen Psychiatry. 2004;61(6):618–27.

Gottlieb MM. Pitocin and autism: an analysis of oxytocin receptor desensitization in the fetus. Behav Brain Res. 2016;298(Pt B):246–7.

Maimburg RD, Vaeth M. Perinatal risk factors and infantile autism. Acta Psychiatr Scand. 2006;114(4):257–64.

Soltys SM, Scherbel JR, Kurian JR, Diebold T, Wilson T, Hedden L, et al. An association of intrapartum synthetic oxytocin dosing and the odds of developing autism. Autism. 2020;24(6):1400–10.

Weisman O, Agerbo E, Carter CS, Harris JC, Uldbjerg N, Henriksen TB, et al. Oxytocin-augmented labor and risk for autism in males. Behav Brain Res. 2015;284:207–12.

Gregory SG, Anthopolos R, Osgood CE, Grotegut CA, Miranda ML. Association of autism with induced or augmented childbirth in North Carolina birth record (1990-1998) and education research (1997-2007) databases. JAMA Pediatr. 2013;167(10):959–66.

Miranda ML, Anthopolos R, Gregory SG. Association of autism with induced or augmented childbirth. Am J Obstet Gynecol. 2014;210(5):492–3.

Freedman D, Brown AS, Shen L, Schaefer CA. Perinatal oxytocin increases the risk of offspring bipolar disorder and childhood cognitive impairment. J Affect Disord. 2015;173:65–72.

Lønfeldt NN, Verhulst FC, Strandberg-Larsen K, Plessen KJ, Lebowitz ER. Assessing risk of neurodevelopmental disorders after birth with oxytocin: a systematic review and meta-analysis. Psychol Med. 2019;49(6):881–90.

Guastella AJ, Cooper MN, White CRH, White MK, Pennell CE, Whitehouse AJO. Does perinatal exposure to exogenous oxytocin influence child behavioural problems and autistic-like behaviours to 20 years of age? J Child Psychol Psychiatry. 2018;59(12):1323–32.

Tichelman E, Warmink-Perdijk W, Henrichs J, Peters L, Schellevis FG, Berger MY, et al. Intrapartum synthetic oxytocin, behavioral and emotional problems in children, and the role of postnatal depressive symptoms, postnatal anxiety and mother-to-infant bonding: a Dutch prospective cohort study. Midwifery. 2021;100:103045.

Stokholm L, Juhl M, Talge NM, Gissler M, Obel C, Strandberg-Larsen K. Obstetric oxytocin exposure and ADHD and ASD among Danish and Finnish children. Int J Epidemiol. 2021;50(2):446–56.

Henriksen L, Wu CS, Secher NJ, Obel C, Juhl M. Medical augmentation of labor and the risk of ADHD in offspring: a population-based study. Pediatrics. 2015;135(3):e672–7.

Seitchik J, Chatkoff ML. Oxytocin-induced uterine hypercontractility pressure wave forms. Obstet Gynecol. 1976;48(4):436–41.

Seitchik J, Chatkoff ML, Hayashi RH. Intrauterine pressure waveform characteristics of spontaneous and oxytocin- or prostaglandin F2alpha--induced active labor. Am J Obstet Gynecol. 1977;127(3):223–7.

Sato M, Noguchi J, Mashima M, Tanaka H, Hata T. 3D power Doppler ultrasound assessment of placental perfusion during uterine contraction in labor. Placenta. 2016;45:32–6.

Lear CA, Wassink G, Westgate JA, Nijhuis JG, Ugwumadu A, Galinsky R, et al. The peripheral chemoreflex: indefatigable guardian of fetal physiological adaptation to labour. J Physiol. 2018;596(23):5611–23.

Westgate JA, Bennet L, Gunn AJ. Fetal heart rate variability changes during brief repeated umbilical cord occlusion in near term fetal sheep. Br J Obstet Gynaecol. 1999;106(7):664–71.

Westgate JA, Bennet L, de Haan HH, Gunn AJ. Fetal heart rate overshoot during repeated umbilical cord occlusion in sheep. Obstet Gynecol. 2001;97(3):454–9.

Bakker PC, Kurver PH, Kuik DJ, Van Geijn HP. Elevated uterine activity increases the risk of fetal acidosis at birth. Am J Obstet Gynecol. 2007;196(4):313:e1–6.

Johnson N, van Oudgaarden E, Montague I, McNamara H. The effect of oxytocin-induced hyperstimulation on fetal oxygen. Br J Obstet Gynaecol. 1994;101(9):805–7.

Simpson KR, James DC. Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. Am J Obstet Gynecol. 2008;199(1):34.e1–5.

Peebles DM, Spencer JA, Edwards AD, Wyatt JS, Reynolds EO, Cope M, et al. Relation between frequency of uterine contractions and human fetal cerebral oxygen saturation studied during labour by near infrared spectroscopy. Br J Obstet Gynaecol. 1994;101(1):44–8.

Aldrich CJ, D'Antona D, Wyatt JS, Spencer JA, Peebles DM, Reynolds EO. Fetal cerebral oxygenation measured by near-infrared spectroscopy shortly before birth and acid-base status at birth. Obstet Gynecol. 1994;84(5):861–6.

Victory R, Penava D, Da Silva O, Natale R, Richardson B. Umbilical cord pH and base excess values in relation to adverse outcome events for infants delivering at term. Am J Obstet Gynecol. 2004;191(6):2021–8.

Oscarsson ME, Amer-Wahlin I, Rydhstroem H, Kallen K. Outcome in obstetric care related to oxytocin use. A population-based study. Acta Obstet Gynecol Scand. 2006;85(9):1094–8.

Burgod C, Pant S, Morales MM, Montaldo P, Ivain P, Elangovan R, et al. Effect of intra-partum oxytocin on neonatal encephalopathy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2021;21(1):736.

Jonsson M, Norden-Lindeberg S, Ostlund I, Hanson U. Acidemia at birth, related to obstetric characteristics and to oxytocin use, during the last two hours of labor. Acta Obstet Gynecol Scand. 2008;87(7):745–50.

Hidalgo-Lopezosa P, Hidalgo-Maestre M, Rodriguez-Borrego MA. Labor stimulation with oxytocin: effects on obstetrical and neonatal outcomes. Rev Lat Am Enfermagem. 2016;24:e2744.

Litorp H, Sunny AK, Kc A. Augmentation of labor with oxytocin and its association with delivery outcomes: a large-scale cohort study in 12 public hospitals in Nepal. Acta Obstet Gynecol Scand. 2021;100(4):684–93.

Milsom I, Ladfors L, Thiringer K, Niklasson A, Odeback A, Thornberg E. Influence of maternal, obstetric and fetal risk factors on the prevalence of birth asphyxia at term in a Swedish urban population. Acta Obstet Gynecol Scand. 2002;81(10):909–17.

Simpson KR, Knox GE. Oxytocin as a high-alert medication: implications for perinatal patient safety. MCN Am J Matern Child Nurs. 2009;34(1):8–15.

Clark SL, Simpson KR, Knox GE, Garite TJ. Oxytocin: new perspectives on an old drug. Am J Obstet Gynecol. 2008;198(4):e4.

El-Kabbany ZA, Toaima NN, Toaima TN, El-Din MYG. Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates? Korean J Pediatr. 2017;60(12):385–9.

Gundur NM, Kumar P, Sundaram V, Thapa BR, Narang A. Natural history and predictive risk factors of prolonged unconjugated jaundice in the newborn. Pediatr Int. 2010;52(5):769–72.

Oral E, Gezer A, Cagdas A, Pakkal N. Oxytocin infusion in labor: the effect different indications and the use of different diluents on neonatal bilirubin levels. Arch Gynecol Obstet. 2003;267(3):117–20.

Sahin HG, Kolusari A, Kamaci M, Kaynak C, Tuncel H. The effect of oxytocin infusion and misoprostol on neonatal bilirubin levels. Arch Gynecol Obstet. 2010;281(1):11–4.

Schneid-Kofman N, Silberstein T, Saphier O, Shai I, Tavor D, Burg A. Labor augmentation with oxytocin decreases glutathione level. Obstet Gynecol Int. 2009;2009:807659.

Karaçor T, Sak S, Başaranoğlu S, Peker N, Ağaçayak E, Sak ME, et al. Assessment of oxidative stress markers in cord blood of newborns to patients with oxytocin-induced labor. J Obstet Gynaecol Res. 2017;43(5):860–5.

Ahmed SN, Ghalib AK. Evaluation of Paraoxonase 1 oxidative stress enzyme in cord blood of newborn to patients delivered with oxytocin induced labor. Iraqi J Med Sci. 2022;20(2):168–74.

Bai DL, Wu KM, Tarrant M. Association between intrapartum interventions and breastfeeding duration. J Midwifery Womens Health. 2013;58(1):25–32.

Eidelman AI, Schanler RJ, Johnston M, Landers S, Noble L, Szucs K, et al. Breastfeeding and the use of human Milk. Pediatrics. 2012;129(3):e827–e41.

Lyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast Milk, a source of beneficial microbes and associated benefits for infant health. Nutrients. 2020;12(4):1–30.

Heesen P, Halpern SH, Beilin Y, Mauri PA, Eidelman LA, Heesen M, et al. Labor neuraxial analgesia and breastfeeding: an updated systematic review. J Clin Anesth. 2021;68:110105.

Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: a literature review. Midwifery. 2021;103:103117.

Andrew MS, Selvaratnam RJ, Davies-Tuck M, Howland K, Davey MA. The association between intrapartum interventions and immediate and ongoing breastfeeding outcomes: an Australian retrospective population-based cohort study. Int Breastfeed J. 2022;17(1):48.

Maeder AB, Vonderheid SC, Park CG, Bell AF, McFarlin BL, Vincent C, et al. Titration of intravenous oxytocin infusion for postdates induction of labor across body mass index groups. J Obstet Gynecol Neonatal Nurs. 2017;46(4):494–507.

Ellis JA, Brown CM, Barger B, Carlson NS. Influence of maternal obesity on labor induction: a systematic review and meta-analysis. J Midwifery Womens Health. 2019;64(1):55–67.

Dawood MY. Pharmacologic stimulation of uterine contraction. Semin Perinatol. 1995;19(1):73–83.

Fuchs AR, Fuchs F. Endocrinology of human parturition: a review. Br J Obstet Gynaecol. 1984;91(10):948–67.

Fuchs AR, Fuchs F, Husslein P, Soloff MS. Oxytocin receptors in the human uterus during pregnancy and parturition. Am J Obstet Gynecol. 1984;150(6):734–41.

Uvnäs Moberg K, Julius H, Handlin L, Petersson M. Editorial: sensory stimulation and oxytocin: their roles in social interaction and health promotion. Front Psychol. 2022;13:929741.

Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(Cd003766):1–134.

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2016;4(Cd004667):1–95.

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Acknowledgements

The authors gratefully acknowledge: librarians from the University of Queensland (Australia) and the University of Skövde (Sweden) for assistance with database search terms, and the University of Queensland librarians who also assisted with manuscript and figure preparation; Jacob Buckley Lennox for additional help with figure preparation; Genna Del Bianco for help with abstract and full-text screening and data extraction; Yoshi Asahara for professional Japanese-to-English translation of Arai (1980) and Professor Soo Downe for chairing the COST action that initiated this review.

Open access funding provided by Swedish University of Agricultural Sciences. Some initial support for this research was provided by COST Action IS1405 BIRTH: https://www.cost.eu/actions/IS1405/ and more recently from COST Action CA18211 DEVOTION: https://www.ca18211.eu Previous publications from this group include systematic reviews in relation to plasma levels of oxytocin in physiological labour and birth and during breastfeeding. See also https://collections.plos.org/collection/birth/ .

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Zada Pajalic

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KUM, AEB, AD, AK, SM, CM, CMM and ZP planned the study. SB and AEB configured the search terms and SB conducted the database searches, including 2022 updates. SB, ZP, KUM, KL, AEB and CM screened abstracts online using Covidence©. SB and KUM conducted full text screening and data extraction and wrote the draft manuscript. SB formulated the tables. SB, KUM, KL, AD, AK, AEB, ZP, LC, SM, CM and CMM revised the manuscript and SB, KL, AD and AK checked and revised the tables. SB developed and designed Fig.  1 with KUM assistance. All authors read and approved the final manuscript.

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Search strings for systematic review: Description: Search strings for systematic review: ‘Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review. Implications for the function of the oxytocinergic system’.

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Buckley, S., Uvnäs-Moberg, K., Pajalic, Z. et al. Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review with implications for the function of the oxytocinergic system. BMC Pregnancy Childbirth 23 , 137 (2023). https://doi.org/10.1186/s12884-022-05221-w

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Received : 21 April 2022

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DOI : https://doi.org/10.1186/s12884-022-05221-w

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