Does pain relief during delivery decrease the risk of postnatal depression?

Hiltunen, Pauliina; Raudaskoski, Tytti; Ebeling, Hanna; Moilanen, Irma

doi:10.1111/j.0001-6349.2004.0302.x

Cited by 95 publications

(83 citation statements)

References 31 publications

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“…The risk of postnatal depression also appears to be higher among those who have had no pain relief at all compared to those with effective analgesia (Hiltunen et al 2004). This is a result from an observational study, however, and does not prove causality.…”

Section: Nature and Assessment Of Labour Painmentioning

confidence: 84%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

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Cover design Raimo Ahonen JUVENES PRINT TAMPERE 2010Volmanen, Petri, Intravenous patient controlled analgesia with remifentanil in early labour. AbstractIn four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1 st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0-10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0-4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression. Keywords

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Section: Nature and Assessment Of Labour Painmentioning

confidence: 84%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

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“…30 Based on this premise, we hypothesized that women's attachment would have an impact on the experience of pain during labour, particularly given that pain is an intense stress that can mobilize internal resources anchored in the attachment style of each woman. Considering that, to the best of our knowledge, the link between attachment and labour pain were not the subject of any research, and given that the experience of labour can be a stressful event that can impact both women's health and their relationships with significant others, 31,32 this study contributes to the study of adult attachment in the context of pain.…”

Section: Discussionmentioning

confidence: 99%

Women’s Attachment as a Predictor of Pain During Labour and Post-Delivery: a Prospective Observational Study

et al. 2014

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Introduction:Labour is considered to be one of the most painful and significant experiences in a woman's life. The aim of this study was to examine whether women's attachment style is a predictor of the pain experienced throughout labour and post-delivery. Material and Methods: Thirty-two pregnant women were assessed during the third trimester of pregnancy and during labour. Adult attachment was assessed with the Adult Attachment Scale -Revised. The perceived intensity of labour pain was measured using a visual analogue scale for pain in the early stage of labour, throughout labour and post-delivery. Results:Women with an insecure attachment style reported more pain at 3 cm of cervical dilatation (p < 0.05), before the administration of analgesia (p < 0.01) and post-delivery (p < 0.05) than those securely attached. In multivariate models, attachment style was a significant predictor of labour pain at 3 cm of cervical dilatation and before the first administration of analgesia but not of the perceived pain post-delivery. Discussion: These findings confirm that labour pain is influenced by relevant psychological factors and suggest that a woman's attachment style may be a risk factor for greater pain during labour. Conclusion:Future studies in the context of obstetric pain may consider the attachment style as an indicator of individual differences in the pain response during labour. This may have important implications in anaesthesiology and to promote a relevant shift in institutional practices and therapeutic procedures.

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“…По данным литературы, ведение родов через естественные родовые пути на фоне эпидураль-ной анальгезии ведет к снижению риска разви-тия послеродовой депрессии [19][20][21][22].…”

Section: Introductionunclassified

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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Does pain relief during delivery decrease the risk of postnatal depression?

Abstract: The mode of pain relief during vaginal delivery seems to be associated with the incidence of postpartum depression, especially immediately after delivery.

Cited by 95 publications

References 31 publications

Intravenous patient-controlled analgesia with remifentanil in early labour

Intravenous patient-controlled analgesia with remifentanil in early labour

Women’s Attachment as a Predictor of Pain During Labour and Post-Delivery: a Prospective Observational Study

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

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