The Relationship Between Women’s Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study

Orbach‐Zinger, Sharon; Landau, Ruth; Harousch, Avi Ben; Ovad, Oren; Caspi, Liron; Kornilov, Evgeniya; Ioscovich, Alexander; Bracco, Danielle; Davis, Atara; Fireman, Shlomo; Hoshen, Moshe; Eidelman, Leonid A.

doi:10.1097/01.aoa.0000547290.01272.9d

Cited by 9 publications

(26 citation statements)

References 7 publications

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“…A few trials showed that untreated pain is associated with a risk of PPD [36,37]. The usage of painkillers can help decrease the incidence of PPD in some cases [38,39]. Our study implied postpartum pain as another risk factor for PPD in the PE group.…”

Section: Discussionsupporting

confidence: 47%

Preeclampsia and Its Complications Exacerbate Development of Postpartum Depression: A Retrospective Cohort Study

shan¹,

ye³

et al. 2020

Preprint

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Background. Hypertensive disorders were proved to be associated with the development of depression. But it is unclear if pregnancy-induced hypertensive diseases, especially preeclampsia (PE), will affect postpartum moods. We aimed to determine the incidence rate of postpartum depression (PPD) in PE patients and comprehensively evaluate the association between PPD and PE, including its severity and complications. Methods. 425 participants including 130 PE mothers were enrolled in this retrospective cohort study. Each woman was asked to complete a questionnaire integrating the Edinburgh Postnatal Depression Scale (EPDS), the Leakage Index Questionnaire, and a pain scale questionnaire within 6 weeks after delivery. The EPDS cut-off score above 13 was recognized as screening positive for PPD. Data between groups were compared by bivariate analysis. Results. PE mothers showed a direct tendency to PPD development. The positive screening for PPD in the PE group was significantly higher than that of the control group (30.77% vs. 14.58%). Based on the results of the regression model, women diagnosed with severe PE and fetal growth restriction were more inclined to develop PPD than normal ones (AOR: 2.759, 95% CI: 1.206-6.315 and AOR: 3.450, 95% CI: 1.596-7.458). It is also indicated that postpartum pain exacerbated the odds of PPD in PE patients (AOR: 1.509, 95% CI: 1.078-2.114). Conclusions. PE was an independent risk factor for PPD. Its severity and complications exacerbate the development of PPD. Doctors and society should pay more attention to PE patients after delivery against the development of PPD.

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Section: Discussionsupporting

confidence: 47%

Preeclampsia and Its Complications Exacerbate Development of Postpartum Depression: A Retrospective Cohort Study

shan¹,

ye³

et al. 2020

Preprint

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“…The lack of association between pain intensity during labor and persistent pain and postpartum depression may therefore partly be caused by a ceiling effect. Nevertheless, the literature is inconclusive when it comes to these associations; some suggest that there is an association [10] and that better pain management during birth could prevent postpartum depression [9,11,41], whilst others do not find any preventive effects of analgesia [12,13,37]. The conflicting findings could be related to methodological issues as mentioned, but could also be related to differences in medical procedures in the various clinics.…”

Section: Associations Between Labor Pain and Postpartum Pain/depressionmentioning

confidence: 99%

“…Some studies suggest there is an association between labor pain and postpartum depression, suggesting that managing labor pain and early postpartum pain decreases the risk for depression [8][9][10]. A recent study even suggest that effective labor pain management with epidural analgesia was associated with reduced postpartum depression symptoms [11].…”

Section: Introductionmentioning

confidence: 99%

Are labor pain and birth experience associated with persistent pain and postpartum depression? A prospective cohort study

Rosseland

Rème

Simonsen

et al. 2020

Scandinavian Journal of Pain

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Background and aimsA considerable research-literature focuses on pain during labor and associations with postpartum persistent pain and depression, with findings pointing in various directions. The aim of this study was to examine the role of labor pain and overall birth experience in the development of pain and depression 8 weeks after delivery.MethodsThe study sample was drawn from the Akershus Birth Cohort. Data from multiple sources were used, including the hospital’s birth record (n = 4,391), questionnaire data from gestational week 17 of pregnancy (n = 3,752), 8 weeks postpartum (n = 2,217), and two questions about pain and birth experience asked within 48 h after delivery (n = 1,221). The Edinburgh Postnatal Depression Scale was used to measure postpartum depression, a single question was used to measure persistent pain 8 weeks postpartum, while pain and birth experience were measured by numeric rating scales. A history of pre-pregnant depression and chronic pain were measured through self-report questions in gestational week 17. A total of 645 women had complete data from all sources. We applied multiple imputation techniques to handle missing responses on the two questions about pain and birth experience.ResultsThe results showed that neither labor pain nor birth experience were associated with persistent pain 8 weeks postpartum, whereas pain before pregnancy (OR 3.70; 95% CI 2.71–5.04) and a history of depression (OR 2.31; 95% CI 1.85–2.88) were statistically significant predictors of persistent pain. A negative birth experience was significantly (OR 1.16; 95% CI 1.04–1.29) associated with postpartum depression, whereas labor pain intensity was not. A history of depression (OR 3.95; 95% CI 2.92–5.34) and pre-pregnancy pain (OR 2.03; 95% CI 1.37–3.01) were important predictors of postpartum depression 8 weeks after delivery.Conclusions and implicationsWhilst the relationship between labor pain intensity and postpartum pain and depression remain unclear, our results do imply the need to screen for previous depression and chronic pain conditions in pregnant women, as well as consider preventive measures in those who screen positive.

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“…Pregnant women often have desires and preferences regarding having a certain mode and type of birth and the extent to which these expectations are fulfilled must be accounted for when examining the contribution of mode and place of birth to birth satisfaction. For example, epidural pain analgesia uptake itself is not as influential to birth satisfaction as the fulfilment of the wish to have a medicated or unmedicated birth [ 16 , 17 ]. Maternal and infant complications during birth such as postpartum haemorrhage, vaginal lacerations, and low Apgar scores have also been found to increase negative appraisals of birth [ 12 , 18 ].…”

Section: Birth Satisfactionmentioning

confidence: 99%

The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women

et al. 2022

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Problem Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. Background The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. Aim To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. Methods 2,341 women who were recruited prenatally in April-May 2020 and reported a live birth between April-October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. Findings The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. Discussion Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. Conclusion Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction.

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The Relationship Between Women’s Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study

Cited by 9 publications

References 7 publications

Preeclampsia and Its Complications Exacerbate Development of Postpartum Depression: A Retrospective Cohort Study

Preeclampsia and Its Complications Exacerbate Development of Postpartum Depression: A Retrospective Cohort Study

Are labor pain and birth experience associated with persistent pain and postpartum depression? A prospective cohort study

The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women

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