Neuraxial labour analgesia is associated with a reduced risk of maternal depression at 2 years after childbirth

Liu, Zhihua; He, Shu-Ting; Deng, Chonghai; Ding, Ting; Xu, Mingjun; Wang, Lei; Li, Xueying; Wang, Dong‐Xin

doi:10.1097/eja.0000000000001058

Cited by 35 publications

(49 citation statements)

References 48 publications

(64 reference statements)

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“…Several lines of evidence have suggested that the risk of postpartum depression is reduced in women who receive epidural analgesia, compared with those without analgesia [22,23]. Liu et al reported that the use of neuraxial analgesia during labor was associated with a reduced risk of postpartum depression at two years after delivery [9].…”

Section: Discussionmentioning

confidence: 99%

“…Severe labor pains are a risk factor of postpartum depression in pregnant women, and early depression is associated with an increased risk of long-term depression [9]. Postpartum depression affects women who have given birth and is a common disorder for new mothers.…”

Section: Introductionmentioning

confidence: 99%

“…Postpartum depression affects women who have given birth and is a common disorder for new mothers. Almost 10-15% of mothers may suffer from postpartum depression within the rst year after delivery [9]. Multiple factors may be involved in postpartum depression, and the causes have been di cult to understand.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

Suzumori

Ebara

Tamada

et al. 2021

Preprint

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Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

Suzumori

Ebara

Tamada

et al. 2021

Preprint

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“…Similar results were also reported by Suhitharan et al [ 18 ] in a case-controlled study, that is, the absence of ELA was an independent risk factor for the development of postpartum depression. Furthermore, a recent study of Liu et al [ 19 ] showed that the use of neuraxial analgesia during labor was associated with a reduced risk of maternal depression at 2 years after childbirth.…”

Section: Ela Postpartum Depression and Children's Neurodevelopmentmentioning

confidence: 99%

“…[ 15 , 16 ] Recent studies suggest that its use is associated with reduced risks of postpartum depression [ 17 , 18 ] and even long-term depression. [ 19 ] Furthermore, ELA may also affect neonates and children, including neonatal status, [ 20 – 22 ] breast-feeding, [ 23 – 25 ] and long-term neurodevelopment; [ 26 , 27 ] but results are conflicting in this aspect. The purpose of this review is to summarize the evidences related to the influences of ELA on the outcomes of neonates and children.…”

Section: Introductionmentioning

confidence: 99%

Potential impact of epidural labor analgesia on the outcomes of neonates and children

Liu

Wang

2020

Chinese Medical Journal

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This review summarizes recent evidences regarding the potential influences of epidural labor analgesia (ELA) on the outcomes of neonates and children. Terms and relevant words including “ELA,” “ELA and neonatal outcomes,” “ELA and children's development,” and “ELA and children's neurocognitive development” were used to search articles published in PubMed database up to October 2019. Original articles and reviews regarding potential influences of ELA on neonates and children were identified. Relevant references of the selected articles were also screened. The anesthetics used during ELA can be absorbed, enter the fetus, and produce neonatal depression; however, these effects are less severe than those during systematic opioid analgesia. The impact of anesthetic exposure during ELA on children's neurodevelopment has not been fully studied, but would be mild if any. ELA increases the risk of intrapartum maternal fever; the latter may be harmful to neonatal outcomes. The use of ELA may increase birth injury by increasing instrumental delivery, although long-term adverse events are rare. On the other hand, ELA may reduce maternal depression and, thus, produce favorable effects on neurocognitive development in childhood; but evidences are still lacking in this aspect. ELA may produce both favorable and unfavorable effects on neonates and children. These effects should be discussed with parturient women before making decisions. The potential harmful effects should be carefully managed. The overall impacts of ELA on neonatal and children's outcomes need to be studied further.

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Obstetric Analgesia and Anesthesia

Grant

2023

Queenan's Management of High‐Risk Pregnancy

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Neuraxial labour analgesia is associated with a reduced risk of maternal depression at 2 years after childbirth

Abstract: Supplemental Digital Content is available in the text

Cited by 35 publications

References 48 publications

Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

Potential impact of epidural labor analgesia on the outcomes of neonates and children

Obstetric Analgesia and Anesthesia

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