Association of postpartum depression and epidural analgesia in women during labor: an observational study

Edipoğlu, İpek Saadet; Aslan, Duygu Demiröz

doi:10.1016/j.bjane.2021.02.021

Cited by 6 publications

(12 citation statements)

References 16 publications

(24 reference statements)

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“…In total, 91 women were enrolled in the final analysis. Similar to studies conducted in Istanbul, the mean age of patients in this study was 30.38 ± 5.09 years [20,25]. Two thirds of mothers were between 25 and 35 years.…”

Section: Discussionsupporting

confidence: 84%

Association between the use of epidural analgesia during labour and incidence of postpartum depression

Ahmad,

Althagafi,

Albluwe

et al. 2023

PLoS ONE

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Introduction Postpartum depression is a significant episode of depression beginning after giving birth. The prevalence of postpartum depression is approximately 20% in Jeddah, Saudi Arabia. Epidural analgesia is the gold standard for labour pain management. Conflicting results exist regarding the association between postpartum depression and epidural analgesia use during labour. Accordingly, this study assessed the association between epidural analgesia use and postpartum depression incidence. Methods A prospective observational study of 170 mothers was conducted, with surveys administered after labour and at six weeks postpartum. Surveys included the following: mothers’ demographics, obstetric history, postpartum depression (Edinburgh Postnatal Depression Scale), and pain severity (Visual Analogue Scale). Results In the final analysis, 91 patients were enrolled. Epidural analgesia was administered to 48.4% of mothers during labour. Nearly two-thirds of mothers learned about EA via sources including family members and social media. However, more than half reported worries regarding epidural analgesia. Edinburgh Postnatal Depression Scale scores showed that 38 mothers (41.8%) likely had depressive symptoms within two days following delivery. Further, 35 (38.5%) met criteria for postpartum depression at six weeks postpartum. For both groups regardless use of analgesia, the mean Visual Analogue Scale score at two days postpartum was 4.16 ± 2.13. Data revealed no correlation between epidural analgesia use and Edinburgh Postnatal Depression Scale within two days and at six weeks postpartum. Multiple regression analysis showed Edinburgh Postnatal Depression Scale scores correlated with Visual Analogue Scale scores but not epidural analgesia use at 1–2 days postpartum. Conclusion This study showed that depressive symptoms resolved in three percent of participants. This suggests that institutions should increase postpartum depression awareness during the antenatal period and implement effective post-delivery screening systems for postpartum depression.

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Section: Discussionsupporting

confidence: 84%

Association between the use of epidural analgesia during labour and incidence of postpartum depression

Ahmad,

Althagafi,

Albluwe

et al. 2023

PLoS ONE

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“…The Japan Environment and Children’s Study (JECS), a prospective cohort study that enrolled registered fetal records ( n = 104,065) in 15 regions nationwide in Japan, showed that vaginal delivery with anesthesia was associated with a higher risk of PPD (aOR: 1.233, 95% CI 1.079–1.409) [ 29 ]. Edipoglu et al conducted another observational study in Turkey of 92 patients and showed that epidural analgesia was strongly correlated with lower depression scores (OR = 0.29, p = 0.0001) [ 30 ]. Furthermore, Lim et al organized a single institutional retrospective observational study on epidural analgesia and the risk of PPD and showed that epidural analgesia was associated with a reduction in the severity of depression symptoms [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Association of General Anesthesia and Neuraxial Anesthesia in Caesarean Section with Maternal Postpartum Depression: A Retrospective Nationwide Population-Based Cohort Study

Hung

Tsao

Yang

et al. 2022

JPM

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Although cesarean section (CS) has become a common method of child delivery in recent decades, the choice between general anesthesia (GA) and neuraxial anesthesia (NA) for CS must be carefully considered. Depending on the type of anesthesia used in CS, a major outcome observed is the occurrence of postpartum depression (PPD). This study investigated the association between PPD risk and the anesthesia method used in CS by using data from three linked nationwide databases in Taiwan, namely, the National Health Insurance Research Database, the National Birth Reporting Database, and the National Death Index Database. After propensity score matching by baseline depressive disorders, maternal demographics, status at delivery, infant’s health, maternal diseases during pregnancy, and age of partner, we included women who had natural births (n = 15,706), cesarean sections with GA (n = 15,706), and cesarean sections with NA (n = 15,706). A conditional logistic regression was used to estimate the odds ratios and 95% confidence intervals (CIs) of PPDs, including depression, sleep disorder, and medication with hypnotics or antidepressants, under anesthesia during CS. The prevalence rates of combined PPDs were 26.66%, 43.87%, and 36.30% in natural births, CS with GA, and CS with NA, respectively. In particular, the proportions of postpartum use of hypnotic drugs or antidepressants were 21.70%, 39.77%, and 31.84%, which were significantly different. The aORs (95% CIs) were 2.15 (2.05–2.25) for the included depressive disorders, 1.10 (1.00–1.21) for depression, 1.03 (0.96–1.11) for sleep disorder, and 2.38 (2.27–2.50) for medication with hypnotics or antidepressants in CS with GA compared with natural births. Women who underwent CS with GA had a significantly higher risk of depressive disorders and a higher need for antidepressants for sleep problems than those who underwent CS with NA. The risks of PPD were significantly associated with the anesthesia method, especially GA. Our results can assist physicians in carefully considering the appropriate anesthesia method for CS delivery, particularly with regard to postpartum drug abuse and drug safety.

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“…PPD is found to depreciate the physical health of the new mothers by causing fatigue, followed by back pain, breast related problems, excessive pain in the perineum and lack of bladder control (Dennis &Vigod, 2019;Slomian et al 2019;Woolhouse et al, 2014). PPD also leads to sleep disorder, excessive weight loss or gain, loss of libido and marked psychomotor retardation among the mothers (Edipoglu & Aslan, 2021).Apart from these, women with PPD also reported to suffer from severe headaches, stomachaches, back pain, lethargy, development (Chen et al, 2013). PPD leads to maternal insensitivity which in turn delays the child's cognitive development (Kaplan, et al, 2014).…”

Section: Maternal Healthmentioning

confidence: 99%

The Silent Suffering: A Perspective on Postpartum Depression

Bhattacharjee¹,

Bhowmik²,

Ghosh³

2023

MAS

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Postpartum Depression (PPD) is a major health concern as it is affecting around 15 per cent of the mothers after delivery. The present paper attempts to explore the different theoretical perspectives of PPD and its risk factors and impacts. For the purpose of the study, a detailed literature search was done and a total of 1467 articles were identified from the year 1950-2021 from various databases namely, PubMed, WebMD, SAGE, Springer, NCBI, Google Scholar, ResearchGate, WHO, APA, Frontiers, Healthline, Scirp, PsycINFO and BMC pregnancy and childbirth, maintaining the inclusion and exclusion criteria. At last, only 91 articles were selected, and a detailed discussion and conclusion have been made accordingly. Findings suggest that it is essential nowadays to protect the health of both the mother and child, and it is a matter of great medical and social importance. Hence, keen attention must be paid to the maternity quality care.

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Association of postpartum depression and epidural analgesia in women during labor: an observational study

Cited by 6 publications

References 16 publications

Association between the use of epidural analgesia during labour and incidence of postpartum depression

Association between the use of epidural analgesia during labour and incidence of postpartum depression

Association of General Anesthesia and Neuraxial Anesthesia in Caesarean Section with Maternal Postpartum Depression: A Retrospective Nationwide Population-Based Cohort Study

The Silent Suffering: A Perspective on Postpartum Depression

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