Pharmacologic labour analgesia and its relationship to postpartum psychiatric disorders: a scoping review

Munro, Allana; MacCormick, Hilary; Sabharwal, Atul J.; George, Ronald B.

doi:10.1007/s12630-020-01587-7

Cited by 10 publications

(8 citation statements)

References 39 publications

(75 reference statements)

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“…The timing for mental health screening also varied among the included studies, and there are only a few speci c recommendations for screening timing. One study describes postpartum mental health conditions to have a natural history, with signi cant depression peaking at 6 weeks and moderate depressive symptoms peaking at 2-3 months and six months (49), and another study reports that postpartum screening for depression should be conducted within six to 12 weeks after birth and be repeated at least once in the rst postnatal year (50). With all these mental health screening instruments, the screening competency of healthcare workers needs to be consistently updated to better understand the screening of postpartum mental health conditions especially postpartum depression and anxiety.…”

Section: Discussionmentioning

confidence: 99%

Mental Health Conditions in the Postpartum Period: A Scoping Study

Ojomo

Alesinloye-King

Erlandsson

et al. 2023

Preprint

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Background Many women experience mental health disorders during the postpartum period, which can develop into chronic or recurrent conditions and might have negative consequences on the quality of parent-infant interactions, long-term mental health of the mother, the family, as well as child development. We aimed to Summarize the current literature on mental health disorders during the postpartum period; from 2 to 52 weeks after childbirth. Methods In this scoping study electronic databases were systematically searched for primary studies published in English between January 2016 and December 2022, and we performed an additional quality appraisal. Descriptive statistics for quantitative data and inductive content analysis for qualitative data were used. Results The final body of literature consisted of 34 articles. Three key categories were identified and used to summarize the literature: mental health screening instruments, postpartum mental health conditions, and associated factors with postpartum mental health. Seventeen different screenings instruments were identified, whereof the Edinburgh Postnatal Depression Scale (EPDS) was the most used. The periods during which the participant’s mental health screening evaluation was conducted varied from four to 52 weeks postpartum, and both single and multiple mental health screenings were common. Six mental health conditions were covered, whereof postpartum depression and postpartum anxiety were the most common. Family and partner support were identified as critical factors associated with development of postpartum menatal health conditions, as well as a history of previous mental health- or medical disorders prior to peripartum. Furhermore, the COVID-19 pandemic had impact on social support, resulting in increased levels of anxiety and depression symptoms, as well as postpartum anxiety. Conclusion Offering a spectrum of support services and care should be made available to all relevant subgroups of mothers throughout pregnancy and up to one year after birth, especially for mothers with pre-existing mental health conditions. Future studies are needed on postpartum psychosis, the effect of long-term postpartum mental health conditions on the child’s well-being, and the fathers’ mental health requires further attention.

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Section: Discussionmentioning

confidence: 99%

Mental Health Conditions in the Postpartum Period: A Scoping Study

Ojomo

Alesinloye-King

Erlandsson

et al. 2023

Preprint

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“… 32 , 33 Thus, despite numerous studies, the association between LEA exposure and PPD risk has not been well established. 34 …”

Section: Childbirth Pain and Postpartum Depressionmentioning

confidence: 99%

“…32,33 Thus, despite numerous studies, the association between LEA exposure and PPD risk has not been well established. 34 In this review, 16 studies including 3 meta-analyses were selected after thorough evaluation (Tables 1 and 2), which assessed the association between LEA and PPD.…”

Section: Childbirth Pain and Postpartum Depressionmentioning

confidence: 99%

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Du¹,

Liu²,

Xu³

et al. 2022

JPR

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Pregnancy and childbirth are major life events for women and their families, characterized by physical, psychological, and emotional changes that can trigger anxiety, depression, and mental disorders in susceptible individuals. Acute labor pain is an independent risk factor for persistent pain in the postpartum period and is associated with depressive disorders. Epidural analgesia is a well-established technique that has commonly been regarded as the gold standard in pain management during labor. Although the relationships between labor pain, labor epidural analgesia, and postpartum depression have been studied by many investigators, the results of these studies are conflicting. Some literature suggest that labor epidural analgesia is associated with a reduction in the incidence of postpartum depression; however, other studies have failed to demonstrate this association. Unmet analgesic needs expectations, unmet birth expectations, and/or the quality of social support during labor may contribute to postpartum depression. The limitations of the published studies included differential misclassification of study variables and residual confounding, variations in the diagnosis of depression, and incomplete history data. Thus, future studies should include information on sociodemographic and patient-level variables and assessments of pain during labor or in the postpartum period. Better management of labor pain should be provided to prevent long-term morbidity and improve maternal and neonatal outcomes. Anesthesiologists could collaboratively work with obstetricians and perinatal psychiatrists to ensure that hospitals prioritize screening and treatment for postpartum depression.

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“…22 The association between labour pain and the development of postpartum psychiatric disorders, particularly PPD, has been the target of recent labour analgesia research. 23 As epidural analgesia remains the most effective modality for ameliorating labour pain, 24 investigators have examined the relationship between PPD and LEA. 7,25,26 This clinical inquiry has yielded mixed results.…”

Section: Re ´Sumementioning

confidence: 99%

“…7,25,26 This clinical inquiry has yielded mixed results. 20,22,23,[25][26][27][28][29][30][31][32][33] The contrasting results exemplify the need for the present large prospective study, which controls for demographic and clinical variables known to influence the risk of PPD. There is a need to identify common and easily modifiable risk factors for PPD to target preventive efforts.…”

Section: Re ´Sumementioning

confidence: 99%

The association between labour epidural analgesia and postpartum depressive symptoms: a longitudinal cohort study

Munro

George

Mackinnon

et al. 2021

Can J Anesth/J Can Anesth

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Background Pain is a risk factor for postpartum depression (PPD) and labour epidural analgesia (LEA) may lower the incidence of PPD. We evaluated depressive symptoms risk at three, six, and 12 months postpartum in women with LEA compared with women without LEA. Methods With ethics approval, hypotheses were tested using data from a longitudinal prospective observational cohort study between January 2015 and January 2019 in nulliparous women aged C 18 yr with uncomplicated, singleton pregnancies. Email surveys were completed at baseline (18-20 weeks' gestation) and at three-, six-and 12 months postpartum, including the Edinburgh

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Pharmacologic labour analgesia and its relationship to postpartum psychiatric disorders: a scoping review

Cited by 10 publications

References 39 publications

Mental Health Conditions in the Postpartum Period: A Scoping Study

Mental Health Conditions in the Postpartum Period: A Scoping Study

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

The association between labour epidural analgesia and postpartum depressive symptoms: a longitudinal cohort study

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