Obstetric anesthesia clinic childbirth course combined with labor epidural analgesia is associated with a decreased risk of postpartum depression : a prospective cohort study

Abstract

Background Postpartum depression (PPD) is a serious complication commonly seen in postnatal women. In this paper, an investigation was conducted to see if obstetric anesthesia clinic childbirth course combined with labor epidural analgesia (LEA) was associated with a decreased risk of PPD. Methods Six hundred fifty-five nulliparous women were enrolled in this prospective cohort study. The parturients were divided into 4 groups, with Group C being the control group, Group AC received the obstetric anesthesia clinic childbirth course only, Group LEA received LEA only, and Group AC + LEA received both the obstetric anesthesia clinic childbirth course and LEA. Maternal and neonatal variables in the perinatal period were recorded. PPD at 6 weeks was assessed using the Chinese version of the Edinburgh Postpartum Depression Scale (EPDS), where a score ≥ 10 is the threshold for PPD. Multivariate logistic regression analysis was performed to assess the association between obstetric anesthesia clinic childbirth course combined with LEA and postpartum depression. Results A total of 124 maternities had EPDS ≥10 points, the incidence of PPD was 18.9%。The incidence of PPD and EPDS scores were significantly lower in Group AC + LEA than in Group C (12.1% vs 26.8%, P < 0.05; 6 (5, 7) vs 7 (5, 11), P < 0.05). Received an anesthesia clinic childbirth course combined with LEA was associated with a decreased risk of PPD (OR 0.273, 95% CI, 0.100–0.743, P = 0.013). Multivariate logistic regression analysis identified 5 other independent factors for PPD, including maternal SAS score in the delivery room, W-DEQ score in the delivery room, living in a confinement center, EPDS score at 1st week postpartum and perinatal care satisfaction . Conclusions Received an obstetrics anesthesia clinic childbirth course combined with LEA for nulliparous women with a single term cephalic pregnancy was associated with a decreased risk of PPD at 6 weeks. Trial registration Chinese Clinical Trial Registry, ChiCTR2000039163. Registered on 20/10/2020.

Persistent Postpartum Pain – A Somatic and Psychologic Perfect Storm

“…Tong et al found that participation in an obstetrical anesthesia clinic combined with epidural anesthesia was associated with a lower rate of PPD. 54 …”

“…Tong et al found that participation in an obstetrical anesthesia clinic combined with epidural anesthesia was associated with a lower rate of PPD. 54 A positive modification of the identifiable risk factors could predictably promote an emotionally more fulfilling birth experience and faster postpartum recovery both physically and psychologically. Traumatic birth experience and postpartum psychological derangements have short-and long-term negative impact on both the mother and the newborn (eg, suicide, killing the newborn, feeding difficulties, impaired psychosocial development of the newborn).…”

“…50,53 A meta-analysis found that ilio-inguinal, ilio-inguinal-iliohypogastric, transversalis fascia, erector spinae, transverse abdominis blocks, wound catheter infusion quadratus lumborum block and wound infiltration improved immediate postoperative analgesia when opioid consumption was used as a metric, 53 however, there are no studies specifically exploring their potential long-term benefit on the reduction of PPP. 54 Systemic and parenteral analgesia can be provided in any phase of labor. For example, inhaled nitrous oxide is being used in many obstetric units during early labor.…”

The Occurrence and Factors Associated with Overt Urinary Retention Among Postpartum Women After Vaginal Delivery with Labor Epidural Analgesia

“…2,[6][7][8] As labor analgesia techniques and concepts have been vigorously implemented in China over the past few years, labor epidural analgesia has been extensively performed in various midwifery institutions nationwide. 9,10 It is worth noting that with the gradually increased rate of labor epidural analgesia, the incidence of PUR has become more widespread and complicated. Existing research has suggested that epidural anesthesia is a vital risk factor for overt PUR.…”