Labor Epidural Anesthesia and Postpartum Depression Risk: Prospective Observation Study and Mendelian Randomization Analysis.

IF 5.1 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S533306

Wei Zheng, Ping Gan, Xianwen Wan, Xiuhong Wang, Jie Gong, Jia Min

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引用次数: 0

Abstract

Background: Postpartum depression is a common mental disorder in mothers. Although the association between pain and depression is generally accepted, it remains uncertain whether labor epidural analgesia can effectively reduce the risk of postpartum depression. The objective of this study was to investigate the association between labor epidural analgesia and postpartum depression.

Methods: A total of 146 parturients with a single-term cephalic pregnancy who were preparing for vaginal delivery were recruited for this observational prospective study. The parturients were divided into a labor epidural analgesia group and a control group (routine care) by preference, with 73 in each group. Sociodemographic characteristics and peripartum data of the parturients were collected. Postpartum depression was defined as a score of ≥ 13 on the Edinburgh Postnatal Depression Scale (EPDS) at 6-weeks postpartum. Multivariable logistic analysis was applied to explore the risk factors for postpartum depression, and Mendelian randomization analyses were used to provide supporting evidence for the association between labor epidural analgesia and postpartum depression at the genetic level. Single-nucleotide polymorphisms associated with epidural or spinal anesthesia and postpartum depression were identified from publicly available genetic dataset of the United Kingdom biobank and FinnGen database.

Results: There was no statistically significant difference in the incidence of postpartum depression at 6-weeks postpartum between the epidural and non-epidural groups [12 (16.4%) vs 7 (9.6%), P = 0.219]. The multivariable logistic model suggested that prepartum EPDS scores, satisfaction with income and marital status, pain level before anesthesia, and comorbidity during pregnancy were independent predictors of postpartum depression incidence. Mendelian randomization analyses indicated that neither labor epidural (OR = 0.90, 95% CI: 0.78-1.05; P = 0.18) nor spinal anesthesia (OR = 1.10, 95% CI: 0.96-1.27; P = 0.17) potentially reduced the risk of postpartum depression.

Conclusion: These findings imply that administration of labor epidural analgesia during delivery has no influence on the incidence of postpartum depression.

Registration number: The study protocol was registered in Chinese Clinical Trial Registry (ChiCTR2300078957).

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查看原文本刊更多论文

分娩硬膜外麻醉与产后抑郁风险：前瞻性观察研究和孟德尔随机化分析。

背景：产后抑郁症是母亲常见的精神障碍。虽然疼痛与抑郁之间的关联已被普遍接受，但分娩硬膜外镇痛是否能有效降低产后抑郁的风险仍不确定。本研究的目的是探讨分娩时硬膜外镇痛与产后抑郁的关系。方法：在这项观察性前瞻性研究中，共招募了146名准备阴道分娩的单足月头位妊娠孕妇。将产妇按偏好分为分娩硬膜外镇痛组和常规护理对照组，每组73例。收集产妇的社会人口学特征及围生期资料。产后抑郁定义为产后6周爱丁堡产后抑郁量表（EPDS）得分≥13分。采用多变量logistic分析探讨产后抑郁的危险因素，采用孟德尔随机化分析在遗传水平上为分娩硬膜外镇痛与产后抑郁的关联提供支持证据。从英国生物银行和FinnGen数据库的公开遗传数据集中确定了与硬膜外或脊髓麻醉和产后抑郁相关的单核苷酸多态性。结果：硬膜外组与非硬膜外组产后6周抑郁发生率比较，差异无统计学意义[12 (16.4%)vs 7 (9.6%), P = 0.219]。多变量logistic模型显示，孕前EPDS评分、收入满意度、婚姻状况、麻醉前疼痛程度、孕期合并症是产后抑郁发生率的独立预测因子。孟德尔随机化分析显示，硬膜外分娩（OR = 0.90, 95% CI: 0.78-1.05; P = 0.18）和脊髓麻醉（OR = 1.10, 95% CI: 0.96-1.27; P = 0.17）均不能降低产后抑郁的风险。结论：分娩时硬膜外镇痛对产后抑郁的发生无影响。本研究方案已在中国临床试验注册中心注册（ChiCTR2300078957）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.