Genetic associations of perinatal pain and depression

McClain, Lora; Farrell, Lia M.; LaSorda, Kelsea R.; Pan, Lisa; Peters, David G.; Lim, Grace

doi:10.1177/1744806919882139

Cited by 5 publications

(4 citation statements)

References 61 publications

(93 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 A genetic association between labor pain and PPD has also been suggested. Since genetic variants are a common factor between perinatal pain and depression, McClain et al 19 identified genetic loci (C/C genotypes for rs4633) that contribute to PPD and pain in a large cohort of perinatal women. These mapped to genetic regions that may elucidate the mechanisms underlying the relationship between PPD and labor pain.…”

Section: Childbirth Pain and Postpartum Depressionmentioning

confidence: 99%

“…7,8 Causes of PPD are multifactorial, ranging from physiological changes related to pregnancy and childbirth, 9 to psychosocial and environmental factors, including a prior history of mental disorders, low levels of social support, stressful life events and traumatic birth, neonatal intensive care administration, and breastfeeding problems. 10 The spread of the coronavirus disease 2019 (COVID- 19) pandemic across borders has also resulted in extensive fear among pregnant women. Data from the literature indicates that the pandemic has had a significant impact on maternal depression during pregnancy and in the postpartum period.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Du¹,

Liu²,

Xu³

et al. 2022

JPR

View full text Add to dashboard Cite

Pregnancy and childbirth are major life events for women and their families, characterized by physical, psychological, and emotional changes that can trigger anxiety, depression, and mental disorders in susceptible individuals. Acute labor pain is an independent risk factor for persistent pain in the postpartum period and is associated with depressive disorders. Epidural analgesia is a well-established technique that has commonly been regarded as the gold standard in pain management during labor. Although the relationships between labor pain, labor epidural analgesia, and postpartum depression have been studied by many investigators, the results of these studies are conflicting. Some literature suggest that labor epidural analgesia is associated with a reduction in the incidence of postpartum depression; however, other studies have failed to demonstrate this association. Unmet analgesic needs expectations, unmet birth expectations, and/or the quality of social support during labor may contribute to postpartum depression. The limitations of the published studies included differential misclassification of study variables and residual confounding, variations in the diagnosis of depression, and incomplete history data. Thus, future studies should include information on sociodemographic and patient-level variables and assessments of pain during labor or in the postpartum period. Better management of labor pain should be provided to prevent long-term morbidity and improve maternal and neonatal outcomes. Anesthesiologists could collaboratively work with obstetricians and perinatal psychiatrists to ensure that hospitals prioritize screening and treatment for postpartum depression.

show abstract

Section: Childbirth Pain and Postpartum Depressionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Du¹,

Liu²,

Xu³

et al. 2022

JPR

View full text Add to dashboard Cite

show abstract

“…Some studies have found a protective relationship between improved pain management and/or labor analgesia and PPD [9–10,11 ▪▪ ,12,13], whereas others have found no relationship [14], or potentially harmful relationships when plans and expectations for labor analgesia utilization do not meet reality [15]. One study found genetic associations between clinical perinatal pain and depression, suggesting a potential biological explanation for these observed relationships between labor pain and depression symptoms [16]. Most observational studies have had limitations including small sample sizes, focus on labor analgesia utilization rather than pain, and incomplete confounding assessment [17 ▪▪ ,18].…”

Section: Labor Pain Analgesia and Depressionmentioning

confidence: 99%

Perinatal depression

Lim

2021

Current Opinion in Anaesthesiology

Self Cite

View full text Add to dashboard Cite

Purpose of reviewPerinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on depression risk, and novel treatments for postpartum depression have been discovered and approved. This article reviews current understandings about birth events on depression, new screening standards, and novel treatments for postpartum depression. Recent findingsPain, analgesia, and depression are complex traits that are inter-related during and after pregnancy. Certain individuals may benefit more than others from addressing pain and suffering around childbirth. Exposures to general anesthesia or postdural puncture headache are associated with postpartum depression symptoms, although a causal relationship is unlikely. Brexanolone, ketamine and its related compounds, and nonpharmacologic options offer new or alternative therapies for depression, although safety information for some of these treatments in pregnancy and lactation are needed. Maternal health bundles call for close attention to perinatal mental health screening with validated instruments, and for timely treatment referrals in the 'fourth trimester'. SummaryClinical monitoring and timely treatment of depression in the perinatal and postpartum periods is critical for maternal postpartum health and recovery. Perinatal specialists and researchers should continue to focus on tailored treatments specific to this special population.

show abstract

“…Fifty-nine single-nucleotide polymorphisms (SNPs) known to be highly correlative with depressive diagnoses were investigated for their relationships with perinatal pain ratings. Results showed 1 SNP (rs4633, a synonymous SNP in COMT ) to be associated with higher “pain right now” ratings (what is your pain right now) at 6 weeks postpartum and 2 other SNPs (rs1135349, an SNP within a small noncoding RNA that has many previous associations for depression, and rs7548151, intronic in ASTN1 ) to be associated with a higher score for emotional valence of labor pain 50. Ongoing research will continue to identify the molecular basis of both acute pain and PPD.…”

Section: Labor Pain and Analgesia: How Anesthesia May Affect Ppdmentioning

confidence: 99%

Perinatal depression

Kroh

Lim

2021

International Anesthesiology Clinics

Self Cite

View full text Add to dashboard Cite

Pregnancy presents a vulnerable period for depressive episodes before, during, and after childbirth. As early as 700 BC, Hippocrates described women having emotional difficulties after giving birth, a problem that came to be termed "the baby blues" and, eventually, "postpartum depression." Symptoms include depressed mood, lack of interest, weight changes, feelings of guilt and worthlessness, difficulty in concentration, and suicidal thoughts. Although the concept became increasingly recognized over the centuries, it was not until 1994 that the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) included the postpartum onset of depression as a formally, medically defined concept in the United States. 1 Today, it is recognized that pregnancy and perinatal depression [postpartum depression (PPD)] may be a more accurate term as the phenomenon can occur at any time surrounding pregnancy and delivery, not just postpartum. The new PPD definition in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) specifies the phenomenon as depression "with perinatal onset" if the onset of mood symptoms occurs during the pregnancy or in the 4 weeks after delivery. 2 Still, the definition may fail to capture appropriate cases because women can experience PPD up to 12 months after giving birth. Generalizing the phenomenon into one category may ignore the distinct needs of women who experience depression in the antepartum versus postpartum periods. 3 Childbirth experiences can affect the risk for PPD. As part of the childbirth experience, labor analgesia and anesthesia can influence childbirth experiences of pain and suffering. Childbirth is one of the most painful experiences that a woman will encounter in her lifetime. There is a growing body of research on the influence of analgesia on PPD risk during this vulnerable period, as it may have protective, neutral, or harmful effects on individuals. This review will summarize the epidemiology of PPD, its natural history, comorbidities, and treatments, and will appraise existing knowledge on the relative contributions of pain, suffering, and analgesia to overall PPD risk.

show abstract

Genetic associations of perinatal pain and depression

Cited by 5 publications

References 61 publications

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Perinatal depression

Perinatal depression

Contact Info

Product

Resources

About