Investigating analgesic and psychological factors associated with risk of postpartum depression development: a case–control study

Abstract

AimThe aim of this study was to investigate the role of peripartum analgesic and psychological factors that may be related to postpartum depression (PPD).MethodsThis case–control study was conducted in pregnant females who delivered at KK Women’s and Children’s Hospital from November 2010 to October 2013 and had postpartum psychological assessment. Demographic, medical, and postpartum psychological status assessments, intrapartum data including method of induction of labor, mode of labor analgesia, duration of first and second stages of labor, mode of delivery, and pain intensity on hospital admission and after delivery were collected. PPD was assessed using the Edinburgh Postnatal Depression Scale and clinical assessment by the psychiatrist.ResultsThere were 62 cases of PPD and 417 controls after childbirth within 4–8 weeks. The odds of PPD was significantly lower (33 of 329 [10.0%]) in females who received epidural analgesia for labor compared with those who chose nonepidural analgesia (29 of 150 [19.3%]) ([odds ratio] 0.47 (0.27–0.8), P=0.0078). The multivariate analysis showed that absence of labor epidural analgesia, increasing age, family history of depression, history of depression, and previous history of PPD were independent risk factors for development of PPD.ConclusionThe absence of labor epidural analgesia remained as an independent risk factor for development of PPD when adjusted for psychiatric predictors of PPD such as history of depression or PPD and family history of depression.

Hair cortisol levels, psychological stress and psychopathological symptoms as predictors of postpartum depression

“…previous miscarriages) have been found to be related to postpartum depression [ 8 , 9 ]. Past histories of psychopathological symptoms or suffering from depression, anxiety, or stress during pregnancy have been reported as psychological variables associated with postpartum depression [ 10 , 11 ]. Fig 1 shows a summary of risk factors associated with postpartum depression in previous studies.…”

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

“…[ 13 , 14 ] It effectively blocks the afferent nociceptive stimulus and blunts the severity of maternal stress response. [ 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.…”

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

“…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].…”

“…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].…”

“…На третьи сутки различий в частоте развития беби-блюза не прослеживали. Наши результа-ты не подтверждают полученные ранее дан-ные P. [19].…”