Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study

Eckerdal, Patricia; Georgakis, Marios K.; Kollia, Natasa; Wikström, Anna‐Karin; Högberg, Ulf; Skalkidou, Alkistis

doi:10.1111/aogs.13275

Cited by 66 publications

(55 citation statements)

References 68 publications

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“…35,38 The A + C DSRS version was completed at 6 weeks postpartum. [20][21][22][23][24][25][26][27][28][29] included questions on bipolar symptoms. All participants were administered section I and in case of a score ≥1, they proceeded to the following sections.…”

Section: Outcomementioning

confidence: 99%

“…Well-known risk factors are previous depression, stress and low socioeconomic status. [21][22][23][24][25][26][27] Women reporting high levels of physical symptomatology at 6 weeks postpartum, have also increased odds of screening positive for PPD. 28 Resilience is considered a moderator of pain and stress and is increasingly acknowledged in clinical practice as a positive psychological resource.…”

Section: Introductionmentioning

confidence: 99%

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Severe obstetric lacerations associated with postpartum depression among women with low resilience – a Swedish birth cohort study

Asif

Mulic‐Lutvica

Axfors

et al. 2020

BJOG

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Objective Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even thoughts of self‐harm. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience. Design Nested cohort study. Setting Uppsala, Sweden. Sample Vaginally delivered women with singleton pregnancies (n = 2990). Methods The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale. A digital acyclic graph was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). A sub‐analysis was run after excluding women with normal or high resilience. Main outcome measures Postpartum depression, assessed with the Depression Self‐Reporting Scale, completed at 6 weeks postpartum. Results There was no significant association between severe obstetric perineal lacerations and PPD at 6 weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR = 4.8, 95% CI 1.2–20), persisting even after adjusting for confounding factors. Conclusion Healthcare professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration. Tweetable abstract Severe perineal lacerations associated with postpartum depression in women with low resilience in a Swedish cohort.

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Section: Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Severe obstetric lacerations associated with postpartum depression among women with low resilience – a Swedish birth cohort study

Asif

Mulic‐Lutvica

Axfors

et al. 2020

BJOG

Self Cite

View full text Add to dashboard Cite

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“…Postpartum perineal pain may have a negative maternal impact, can affect the quality of life of the mother, and may be severe enough to disturb the postpartum period and the mother-infant dyad [5,6]. Symptoms of postpartum depression affect 10-15% of women [12,13]. An association between persistent perineal pain and symptoms of postpartum depression has been identified by several studies [14,15].…”

Section: Introductionmentioning

confidence: 99%

Ropivacaine 75 mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women – the ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trials

Cardaillac

Ploteau

Thuaut

et al. 2020

Trials

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Background: Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy but have only focused on the immediate postpartum period (at 24 and 48 h after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and mid-and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods/design: The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial being conducted in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75 mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (midterm), defined by the Numeric Pain Rating Scale (NPRS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (NPRS) and the impact of pain on daily behavior, on the quality of life (36-item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale), and on sexual health (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show approximately 30% relative risk reduction in the incidence of perineal pain at day 7, from 70.0% to 50.0%.

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“…Postpartum perineal pain may have a negative maternal impact and can affect the quality of life of the mother and may be severe enough to disturb the postpartum period and the mother-infant dyad [5,6]. Symptoms of postpartum depression affect 10-15% of women [12,13]. An association between persistent perineal pain and symptoms of postpartum depression has been identi ed by several studies [14,15].…”

Section: Introductionmentioning

confidence: 99%

Ropivacaine 75mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women- The ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trial.

Cardaillac

Ploteau

Thuaut

et al. 2020

Preprint

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Background Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have already investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy, but have only focused on the immediate postpartum period (at 24 and 48 hours after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and mid- and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (mid-term), defined by the numerical rating scale of pain (ENS NRS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (ENS NRS), the impact of pain on daily behavior, on the quality of life (36-Item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale) and on sexuality (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show approximately 30% relative risk reduction in the incidence of perineal pain at day 7, from 70.0% to 50.0%. Discussion Ropivacaine is a promising candidate drug, inexpensive, easy to administer, and would be suitable to include in the routine management of deliveries in labor ward. This study will investigate if perineal ropivacaine infiltration just after birth can reduce mid- and long-term postpartum pain and increase quality of life in women with mediolateral episiotomy.

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Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study

Cited by 66 publications

References 68 publications

Severe obstetric lacerations associated with postpartum depression among women with low resilience – a Swedish birth cohort study

Severe obstetric lacerations associated with postpartum depression among women with low resilience – a Swedish birth cohort study

Ropivacaine 75 mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women – the ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trials

Ropivacaine 75mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women- The ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trial.

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