Preterm Labor Using Tocolysis as a Possible Risk Factor for Postpartum Depression: A 14-Year Population-Based Study in Taiwan

Abstract

Postpartum depression (PPD) is associated with negative physical and mental health outcomes for the mother and infant. Women often experience elevated symptoms of PPD, and the incidence of PPD has increased in recent years. There were lack of studies to investigate the effects of medications during pregnancy. Herein, we focused on the most common obstetric medical therapies used in labor and determined whether the medical therapies cause mental stress in pregnant women. This 14-year retrospective population-based nationwide study was based on the National Health Insurance Research Database. Univariate and multivariate logistic regression analyses were used to evaluate unadjusted and adjusted odds ratios and 95% confidence intervals for each tocolytic and uterotonic treatments during pregnancy and common medical illnesses. In comparing the effects of tocolytic and uterotonic medications on maternal PPD, tocolysis with the injection form of ritodrine resulted in a significantly higher risk of PPD based on multivariate analysis. This study supports existing research demonstrating an association between tocolysis with ritodrine and PPD. Ritodrine treatment for preterm labor was a significant risk factor for PPD, especially the injection form. This information provides obstetricians and health policy providers to pay attention to maternal mental health outcomes among high-risk pregnant women.

Ritodrine-induced rhabdomyolysis and psychiatric symptoms: a case report and literature review

“…None of these agents was considered capable of inducing the occurrence of psychiatric symptoms. Liu et al [ 20 ] performed a 14-year retrospective study and found that ritodrine treatment for preterm labor was a significant risk factor for postpartum depression, especially in the form of an injection. This study lets us link the psychiatric symptoms of the patient in the present study with ritodrine.…”

Tocolytic Treatment for the Prevention of Preterm Birth from a Taiwanese Perspective: A Survey of Taiwanese Obstetric Specialists

“…According to the Global Health Observatory by the World Health Organization, complications of prematurity are a leading cause of death under 5 years of age, with 964,366 deaths in 2017 alone, accounting for 17.8% of the under-5-mortality globally [ 6 , 7 ]. Furthermore, preterm birth is a great burden to the healthcare system as well as a source of substantial financial and psychological hardship [ 8 , 9 , 10 ].…”