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. 2017 Oct 31:10:99-104.
doi: 10.2147/LRA.S141569. eCollection 2017.

Administration of epidural labor analgesia is not associated with a decreased risk of postpartum depression in an urban Canadian population of mothers: a secondary analysis of prospective cohort data

Marissa Nahirney  1 , Amy Metcalfe  2 , Katie H Chaput  3
Affiliations

Administration of epidural labor analgesia is not associated with a decreased risk of postpartum depression in an urban Canadian population of mothers: a secondary analysis of prospective cohort data

Marissa Nahirney et al. Local Reg Anesth. .

Abstract

Background: Postpartum depression (PPD) is a common complication of pregnancy, affecting approximately 13% of mothers internationally. Previous research has examined whether epidural analgesia used for pain control during labor and birth is associated with a lower risk of PPD, but reports conflicting results and may have suffered from methodological shortcomings. Our study aimed to prospectively assess whether epidural analgesia is associated with a lower risk of PPD (at either 6 weeks or 6 months postpartum) after attempting to adequately adjust for selection bias and confounding variables.

Methods: We conducted a secondary analysis of a prospective cohort of urban Canadian mothers who were recruited at birth in Calgary, Canada, in 2010, for a primary study on predictors of PPD. Mothers with full-term, singleton infants who did not require neonatal intensive care unit admission of >24 hours were included, and filled out questionnaires at birth, 6 weeks and 6 months postpartum including demographics, birth data, maternal and infant physical health, lifestyle, breastfeeding and maternal mental health. Descriptive statistics were calculated for participant characteristics and to identify potential confounder variables. Multivariable logistic regression analysis was conducted to assess whether epidural analgesia is associated with PPD after controlling for available confounding variables.

Results: Our study included 206 mothers who had vaginal deliveries and were free of depression at delivery. We found an incidence of PPD of 13.3% (n=27) and no statistically significant association between epidural use and PPD, regardless of adjustment for potential confounding variables (unadjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.69-1.22; adjusted OR (for body mass index 1.04, 95% CI 0.40-2.77).

Conclusion: We did not observe a significant association between epidural use and PPD. While the CIs are wide, we do not believe that this masks a clinically relevant association, and as such, the risks and benefits of epidural analgesia communicated to women during labor and delivery should not be modified.

Keywords: epidural analgesia; labor analgesia; maternal mental health; postpartum depression.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Comparison of participant characteristics to population values.
See this image and copyright information in PMC

References

    1. O’Hara M, Swain A. Rates and risk of post partum depression – a meta-analysis. Intern Rev psychiatr. 1996;8:37–54.
    1. O’Hara WM. Postpartum depression: what we know. J Clin Psychol. 2009;65(12):1258–1269. - PubMed
    1. Lewis G. DSM-IV Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1996.
    1. Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive development and behaviour: a review and critical analysis of the literature. Arch Womens Ment Health. 2003;6:263–274. - PubMed
    1. Dennis C-L, McQueen K. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics. 2009;123(4):e736–e751. - PubMed

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