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已发表论文
分娩硬膜外麻醉与产后抑郁风险：前瞻性观察研究及孟德尔随机化分析
Authors Zheng W, Gan P, Wan X, Wang X, Gong J, Min J
Received 9 April 2025
Accepted for publication 28 August 2025
Published 15 September 2025 Volume 2025:19 Pages 8327—8338
DOI https://doi.org/10.2147/DDDT.S533306
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Mariana Carmen Chifiriuc
Wei Zheng, Ping Gan, Xianwen Wan, Xiuhong Wang, Jie Gong, Jia Min
Department of Anesthesiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China
Correspondence: Jia Min, Department of Anesthesiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yongwai Main St., Nanchang, People’s Republic of China, Email ndyfy02136@ncu.edu.cn
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).
Keywords: postpartum depression, labor epidural analgesia, neuraxial anesthesia, prospective observation study, Mendelian randomization
Department of Anesthesiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China
Correspondence: Jia Min, Department of Anesthesiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yongwai Main St., Nanchang, People’s Republic of China, Email ndyfy02136@ncu.edu.cn
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).
Keywords: postpartum depression, labor epidural analgesia, neuraxial anesthesia, prospective observation study, Mendelian randomization