A systematic review of the association between postpartum depression and neuraxial labor analgesia
| Autor: | Stephen H. Halpern, Sharon Orbach-Zinger, Sophie Grigoriadis, M. Heesen, Philip Heesen |
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| Rok vydání: | 2021 |
| Předmět: |
Postpartum depression
medicine.medical_specialty law.invention Depression Postpartum 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Pregnancy 030202 anesthesiology law medicine Humans Pain Management Analgesics 030219 obstetrics & reproductive medicine Obstetrics business.industry Incidence (epidemiology) Confounding Parturition Obstetrics and Gynecology Odds ratio medicine.disease Analgesia Epidural Anesthesiology and Pain Medicine Edinburgh Postnatal Depression Scale Analgesia Obstetrical Female Observational study business Cohort study |
| Zdroj: | International Journal of Obstetric Anesthesia. 45:142-149 |
| ISSN: | 0959-289X |
| Popis: | Background Postpartum depression (PPD) is the most common complication after childbirth, affecting 10–15% of women. It is associated with serious long-term consequences for the mother and family. Whether or not neuraxial labor analgesia mitigates the risk is uncertain and controversial. The purpose of this review was to summarize studies investigating the association between neuraxial labor analgesia and the incidence of PPD. Methods A systematic literature search for randomized controlled trials and cohort studies reporting the incidence of PPD among parturients who received neuraxial analgesia compared with non-neuraxial or no analgesia. The primary outcome was the incidence of PPD between 5 and 12 weeks’ postpartum. Depression was diagnosed using a cutoff score of ≥10 on the Edinburgh Postnatal Depression scale, a validated screening tool. The risk of bias of each study was evaluated, and odds ratios and 95% confidence intervals calculated from raw data or reported as adjusted odds ratios. Results Eleven observational studies involving 5717 patients were included. Three studies had a critical risk, three a serious risk, and five a moderate risk of bias. Two studies reported significantly lower odds for PPD associated with neuraxial analgesia compared with non-neuraxial or no analgesia, whereas the odds ratios in the remaining nine studies were not significantly different. Conclusions Our systematic review did not find compelling evidence for an association between PPD and labor analgesia. Studies were heterogenous in nature and had a high risk of bias. Further research controlling for confounding factors is recommended to determine if a relationship exists. |
| Databáze: | OpenAIRE |
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