Epidural linked to lower risk of post-partum depression

Controlling childbirth pain appears to lower the risk of postpartum depression, researchers reported in a July 23 editorial in Anesthesia & Analgesia.

Katherine Wisner, M.D., director of Northwestern University’s Asher Center for the Study and Treatment of Depressive Disorders, based her editorial on a new Chinese study in which subjects receiving epidural anesthesia during a vaginal delivery achieved a much lower risk for postpartum depression than subjects who did not have an epidural.

“It’s a huge omission that there has been almost nothing in postpartum depression research about pain during labor and delivery and postpartum depression,” Wisner said. “There is a well-known relationship between acute and chronic pain and depression.”

“Maximizing pain control in labor and delivery with your obstetrician and anesthesia team might help reduce the risk of postpartum depression,” Wisner added.

The Chinese researchers studied 214 women who were in labor and were prepared for vaginal delivery. Of these subjects, 107 requested and received epidurals.

Clinicians assessed the mental health of all subjects starting three days after delivery and until to six weeks after delivery, using a standard scale for measuring postpartum depression.

They found that that subjects who had undergone epidural had a 14 percent rate of depression at six weeks postpartum compared to nearly 35 percent rate for subjects who did not have the procedure. An epidural was the only available pain control in the study.

“These findings are quite exciting and further research should be done to confirm them, especially in women at increased risk of postpartum depression and in women from other cultures,” Wisner said.

Wisner is also is a professor of psychiatry and behavioral sciences and obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a psychiatrist at Northwestern Memorial Hospital.