The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis

Abstract

Background: Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression. Methods: We performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model. Results: Of the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94). Conclusion: Based on current literature, the use of epidural analgesia for pain relief during labor doesn't appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.

Analysis factors affecting postpartum depression in postpartum mothers during the COVID-19 pandemic

“…The results of statistical tests obtained a p-value of <0.05. Thus, it can be concluded that there is a significant relationship between physical exercise and postpartum depression (Almeida et al, 2020). This is in line with the literature that the lack of family support, especially from husbands and other close family members can trigger postpartum depression (Rosenthal & Henderson, 2003;Wolwan, 1993cit Hutagaol, 2010.…”

Unexpected changes in birth experiences during the COVID-19 pandemic: Implications for maternal mental health

“…It is intriguing that not receiving the desired medication was associated with increased depressive symptoms in the postpartum period. While epidural anesthesia during labor is neither a risk factor nor a protective factor against postpartum depression [45][46][47], unmatched expectations of medications during labor have been demonstrated to result in higher rates of postpartum depression [48,49]. Relative risk of postpartum depression appears to be higher both for those who intended to deliver with epidural anesthesia during labor, but did not receive it [49], as well as those who intended not to deliver with epidural anesthesia but ultimately received it [48,49].…”

Childbirth Pain and Post-Partum Depression: Does Labor Epidural Analgesia Decrease This Risk?

“…Aggregated effect of the studies that investigated PPD among women who received epidural analgesia compared to controls found no significant differences (OR 1.02, 95% CI, 0.62–1.66). 19 Overall, this meta-analysis showed a lack of association between the use of epidural analgesia and postpartum depression. These observational studies cannot account for unknown confounders, which can only be adequately managed by randomized clinical trials.…”