Epidural Labor Analgesia Is Associated with a Decreased Risk of Postpartum Depression

Ding, Ting; Wang, Dong‐Xin; Yuan, Qing; Chen, Qian; Zhu, Sai-Nan

doi:10.1213/ane.0000000000000107

Cited by 126 publications

(135 citation statements)

References 41 publications

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“…The absolute difference in rates of breastfeeding initiation and duration vary by setting and are likely influenced by a range of factors such as intervention fidelity, social factors, and others. Although our scope is narrower (in terms of eligible country setting and study design), our conclusions are consistent with a recent narrative review 226 focused on BFHI; the authors conclude that adherence to the BFHI Ten Steps has a positive influence on breastfeeding outcomes. In terms of other health care interventions, staff training alone (without other breastfeeding support components) did not lead to improved breastfeeding outcomes.…”

Section: Findings In Relation To What Is Already Knownsupporting

confidence: 87%

“…We identified no eligible studies assessing workplace breastfeeding interventions; other reviews have highlighted the lack of controlled trials of workplace interventions for promoting breastfeeding in employed women. 26,226 We looked for both trials and observational studies with a control group and still found no eligible studies. The absence of evidence on this topic precludes us from commenting on the effectiveness of workplace breastfeeding interventions.…”

Section: Findings In Relation To What Is Already Knownmentioning

confidence: 99%

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Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries

Feltner¹,

Weber²,

Stuebe³

et al. 2018

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ii Key Messages Purpose of ReviewTo summarize the effectiveness of community, workplace, and health care system-based programs and policies aimed at supporting and promoting breastfeeding, and to determine the association between breastfeeding and maternal health Key Messages• Baby-Friendly Hospital Initiative (BFHI) is associated with improved rates of breastfeeding initiation and duration.• Health care staff education combined with postpartum home visits may be effective for increasing breastfeeding duration.• Health care staff education alone (with no additional breastfeeding support services) may not be effective for increasing breastfeeding initiation rates.• For women enrolled in the WIC Program, peer-support interventions offered by WIC agencies may improve rates of breastfeeding initiation and duration.• Breastfeeding is associated with reduced maternal risk of breast and ovarian cancer, hypertension, and type 2 diabetes.• Workplace, school-based, and community-based interventions and underlying socioeconomic factors need further research.iii This report was funded by the Office on Women's Health at the Office of the Assistant Secretary for Health (OASH) and the Centers for Disease Control and Prevention (CDC) through an interagency agreement with the Agency for Healthcare Research and Quality (AHRQ) and is based on research conducted by the RTI International-University of North Carolina Evidencebased Practice Center (EPC) under contract to AHRQ, Rockville, MD (Contract No. 290-2015-00011-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.The information in this report is intended to help health care decisionmakers-patients and clinicians, health system leaders, and policymakers, among others-make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.AHRQ or U.S. Department of Health and Human Service...

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Section: Findings In Relation To What Is Already Knownsupporting

confidence: 87%

Section: Findings In Relation To What Is Already Knownmentioning

confidence: 99%

Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries

Feltner¹,

Weber²,

Stuebe³

et al. 2018

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“…Опубликованный в 2006 г. мета-анализ U. Halbreich и S. Karkun с включени-ем 143 исследований, посвященных частоте встречаемости ПРД по всему миру, продемон-стрировал, что распространенность депрес-сии составляет от 0 до 60 % в зависимости выбранного времени оценки в послеродовом периоде и используемых шкал [6]. В Германии 3,6 % родильниц заболевают депрессией в по-слеродовом периоде [7], в Японии депрессия после родов зарегистрирована у 17 % родиль-ниц [8], в США -у 10-20 % женщин [28], в Сингапуре -у 8 % [29], в Китае -у 24,3 % [5].…”

Section: обсуждение полученных результатовunclassified

“…Критическим проявлением ПРД могут быть суицидальные мысли [1][2][3][4]. По данным различных авторов, частота встре-чаемости ПРД составляет от 0 до 60 % [5][6][7][8]. Проведенный M.W.…”

Section: Introductionunclassified

“…Эпидуральная анальгезия (ЭА) считается «золотым стандартом» облегчения боли во вре-мя родов, так как, по мнению ряда авторов, наиболее полно отвечает требованиям, предъ-являемым к анальгезии, используемой в родах, и позволяет матерям в полной мере участво-вать в процессе родов без седации [5,[17][18][19][20].…”

Section: Introductionunclassified

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Labor pain relief and postpartum depression. Is there a correlation?

et al. 2017

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The article is dedicated to the evaluation of the effect of labor pain relief by using epidural analgesia during vaginal delivery on the frequency of postpartum depression. Materials and methods. 159 women were included in the study. The average age of the patients was 29 years, the average gestation period was 39.7 weeks. In the first group, in order to relief the pain while vaginal birth, an epidural analgesia was administered. A continuous patient-controlled infusion was used along with 0.08% solution of ropivacaine hydrochloride in the capacity of a local anesthetic. Patients of the second group gave birth without any anesthesia. Evaluation of the depression progress was carried out several times: before birth, 6 hours after delivery, 3 days and 6 weeks after delivery. Results of the study. Usage of epidural analgesia during vaginal delivery leads to a significant pain syndrome relief, but does not reduce the probably of postpartum depression.

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Safety of non‐steroidal anti‐inflammatory drugs in postpartum period in women with hypertensive disorders of pregnancy: systematic review and meta‐analysis

Bellos

Pergialiotis

Antsaklis

et al. 2020

Ultrasound in Obstet & Gyne

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Objective To assess the effect of non‐steroidal anti‐inflammatory drugs (NSAIDs) on blood pressure when administered for postpartum analgesia in women with hypertensive disorders of pregnancy. Methods MEDLINE, Scopus, CENTRAL, http://Clinicaltrials.gov and Google Scholar databases were searched systematically from inception to 5 December 2019 for studies evaluating the safety of postpartum NSAIDs in women with any gestational hypertensive disorder. Randomized controlled trials (RCTs) and cohort studies were eligible for inclusion. Case–control studies, case series and case reports were excluded. The primary outcomes of interest were the incidence of severe hypertension and systolic, diastolic and mean arterial blood pressure. Pooled estimates were obtained by fitting a random‐effects statistical model. The quality of evidence was assessed according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. Results Ten studies were included, comprising five RCTs and five retrospective cohort studies and involving a total of 1647 women. All studies were evaluated qualitatively and eight of them were included in the quantitative meta‐analysis. Administration of NSAIDs was not associated with a significantly higher risk of severe postpartum hypertension (odds ratio, 1.52 (95% CI, 0.77–3.01)). Similarly, no significant differences were found in postpartum systolic blood pressure (mean difference (MD), –3.03 mmHg (95% CI, –6.21 to 0.15 mmHg)) and mean arterial pressure (MD, –0.38 mmHg (95% CI, –1.88 to 1.11 mmHg)) between women who received NSAIDs and those who did not, whereas postpartum diastolic blood pressure was marginally lower in women treated with NSAIDs (MD, –2.28 mmHg (95% CI, –4.44 to –0.13 mmHg)). The same effects were observed when studies with a large sample size, RCTs, women with severe pre‐eclampsia and studies using ibuprofen as the study drug and acetaminophen as the control treatment were examined separately. The credibility of evidence was judged to be very low according to GRADE, owing to concerns about study limitations, inconsistency and imprecision. Conclusions This meta‐analysis suggests that postpartum administration of NSAIDs is not associated with elevated blood pressure in women with hypertensive disorders of pregnancy. However, the existing evidence is of very low quality, thus future large‐scale RCTs are warranted to verify the safety of postpartum NSAIDs in this population. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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Epidural Labor Analgesia Is Associated with a Decreased Risk of Postpartum Depression

Abstract: Epidural labor analgesia was associated with a decreased risk of postpartum depression. Further study with a large sample size is needed to evaluate the impact of epidural analgesia on the occurrence of postpartum depression.

Cited by 126 publications

References 41 publications

Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries

Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries

Labor pain relief and postpartum depression. Is there a correlation?

Safety of non‐steroidal anti‐inflammatory drugs in postpartum period in women with hypertensive disorders of pregnancy: systematic review and meta‐analysis

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