A large retrospective study presented here at the 2018 Annual Meeting of the American Society of Anesthesiologists (ASA) has found that adequate postpartum pain control is associated with a decreased risk of postpartum depression.
Recent studies have suggested that epidural analgesia is linked to a reduced risk of postpartum depression. One study of 214 women in labour found that postpartum depression occurred in 14.0% of patients who received epidural labour analgesia and in 34.6% of those who did not (P< .001). However, it is still unclear if postpartum pain is associated with postpartum depression.
For the current study, Jie Zhou, MD, Brigham & Women’s Hospital, Boston, Massachusetts, and colleagues performed a retrospective analysis of all term, singleton, and nulliparous women who delivered at a major teaching institution from June 1, 2015 to December 31, 2017.
Of 4,327 participants, those who had postpartum depression had higher maternal body mass index, worse Apgar 1-minute and 5-minute scores, and lower baby weight and length (P< .001).
Subjects in the post-partum depression group demonstrated significantly higher postpartum pain (P< .0001).
Among women with postpartum depression, the use of an epidural was lower (P< .0001).
The authors noted that more women in the post-partum depression group had medical history of depression, anxiety, obesity, asthma, abnormal glucose, substance/drug/physical/sexual abuse, and chronic pain (P< .001).
The researchers noted that it may be the postpartum pain — not the labour pain — that may be the culprit for postpartum depression.
While non-steroid anti-inflammatory medication can help postpartum pain, those with depression may need additional analgesia and denser control after delivery.