EFFECT OF PAIN RELIEF IN DELIVERY ON THE FREQUENCY OF POSTPARTUM DEPRESSION IN NEW MOTHERS
https://doi.org/10.21292/2078-5658-2017-14-1-29-35
Abstract
The article evaluates the effect of various anesthetic techniques in delivery on the frequency of postpartum depression in new mothers. Materials and methods. 209 women were enrolled into the study, medium age made 31 years and gestation period made 39.4 weeks. All patients were divided into 4 groups: groups 1 and 2 had vaginal delivery; continuous epidural anesthesia was used in group 1, 0.08% solution of ropivacaine hydrochloride was used as a local anesthetic. No pain relief was used in group 2. Cesarean section with intraspinal anesthesia was performed in groups 3 and 4; transversus abdominis plane block with parenteral administration of non-steroidal anti-inflammatory agents was used in group 3. Only system narcotic analgesics and non-steroidal anti-inflammatory agents were used for anesthetic purposes in group 4. Specific features of postpartum depression were searched for within the following time periods: in 6 hours, 3 days and 6 weeks after the delivery. Results of the study. It has been found out that using continuous epidural anesthesia for pain relief purposes during vaginal delivery results in no reduction of postpartum depression frequency in 6 weeks after the delivery compared to the patients who had no anesthesia during delivery. No effect of delivery type on postpartum depression frequency has been observed. The reduction of postpartum blues has been noted when transversus abdominis plane block was used as a part of multi-modal pain relief. No effect of transversus abdominis plane block on the postpartum depression development in 6 weeks after delivery has been observed.
About the Authors
O. V. RyazanovaRussian Federation
Candidate of Medical Sciences, Associate Professor of Anesthesiology, Intensive Care and Emergency Pediatrics Department
Yu. S. Aleksandrovich
Russian Federation
Doctor of Medical Sciences, Professor of Anesthesiology, Intensive Care and Emergency Pediatrics Department within Professional Development Unit
I. A. Gorkovaya
Russian Federation
Doctor of Psychological Sciences, Professor, Head of Psychosomatic Medicine and Behavioral Therapy Department
M. A. Korgozha
Russian Federation
Psychologist, Assistant of Clinical Psychology Department
Yu. V. Koshkina
Russian Federation
General Practitioner
A. M. Ioskovich
Israel
Shaare Zedek Medical Center, Head of High Risk Anesthesiology, Senior Lecturer of Medical Department
References
1. Аleksandrovich Yu.S., Murieva E.А., Pshenisnov K.V. et al. Specific features of hormonal status of the mother and newborn when using continuous epidural anesthesia in delivery. Pediatr, 2011, no. 4, pp. 51-55. (In Russ.)
2. Golubovich V.V. Kliniko-epidemiologicheskoe issledovanie poslerodovoy depressii. Avtoref. diss. kand. med. nauk. [Clinical and epidemiological study of postpartum depression. Cand. Diss.]. Minsk, 2004, 22 p.
3. Zabolotskiy D.V., Ryazanova O.V., Mamsurov А.S. et al. Variant of post-operative anesthesia in cesarean section. What is to be chosen? Regionar. Anestesia i Lecheniye Ostroy Boli, 2013, pp. 16-20. (In Russ.)
4. Kuliev R.T., Ruzhenkov V.А. Psychiatric disorders in the regular course of pregnancy (clinical structure and treatment). Tyumen. Med. Journal, 2012, no. 1, pp. 27-28. (In Russ.)
5. Lantsev E.А., Аbramchenko V.V. Аnesteziya, intensivnaya terapiya i reanimatsiya v akusherstve. [Anesthesia and intensive care in obstetrics]. Moscow, MEDpress-Inform Publ., 2010.
6. Mazo G.E., Vasserman L.I., Shamanina M.V. Selection of evaluation scores of postpartum depression. Obozrenie Psikhiatrii i Meditsinskoy Psikhologii, 2012, no. 2. pp. 41-50. (In Russ.)
7. Pribytkov А.А. Klinicheskie osobennosti depressivnykh rasstroystv nevroticheskogo urovnya v poslerodovom periode. Diss. kand. med. nauk. [Clinical features of neurotic depressions in the postpartum period. Cand. Diss.]. St. Petersburg, SPb NIPNI im. V.M. Bekhtereva Publ., 2006, 22 p.
8. Smulevich А.B. Depressii v obschey meditsine: rukovodstvo dlya vrachey. [Depressions in general medicine. Doctors' guidelines]. Moscow, MIA Publ., 2001, 256 p.
9. Shifman E.M., Ermilov Yu.N. Effect of epidural anesthesia on the delivery course. Ros. Vestn. Akushera-Ginekologa, 2006, vol. 6, no. 1, pp. 44-46. (In Russ.)
10. Yakhin K.K., Mendelevich D.M. Klinicheskiy oprosnik dlya vyavleniya i otsenki nevroticheskikh sostoyaniy. Klinicheskaya i meditsinskaya psikhologiya: Prakticheskoe rukovodstvo. [Clinical questionnaire for detection and assessment of neurotic disorders. Clinical and medical psychology. Handbook]. Moscow, 1998, pp. 545-552.
11. Alharbi A.A., Abdulghani H.M. Risk factors associated with postpartum depression in the Saudi population. Neuropsych. Dis. Treatment, 2014, vol. 10, pp. 311-316.
12. Ballestrem C.L., Strauss M., Kächele H. Contribution to the epidemiology of postnatal depression in Germany-implications for the utilization of treatment. Arch. Womens Ment. Health, 2005, vol. 8, pp. 29-35.
13. Banasiewicz J., Wójtowicz S. The quality of life after cesarean section. Review article. Neuropssychologiica, 2010, vol. 3, pp. 273-283.
14. Bergant A., Nguyen T., Heim K. et al. Deutschsprachige Fassung und Validierung der «Edinburgh postnatal depression scale». Dtsch. Med. Wochenschr., 1998, vol. 123, pp. 35-40.
15. Boudou M., Teissedre F., Walburg V. et al. Association between the intensity of childbirth pain and the intensity of postpartum blues. Encephale, 2007, vol. 33, no. 5, pp. 805-810.
16. Chen H. Addressing maternal mental health needs in Singapore. Psychiatr. Serv., 2011, vol. 62, no. 1, pp. 102.
17. Cox J., Chapman G., Murray D. et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J. Affect. Disord., 1996, vol. 39, pp. 185-189.
18. Ding T., Wang D.X., Qu Y. et al. Epidural labor analgesia is associated with a decreased risk of postpartum depression: a prospective cohort study. J. Anesth Analg., 2014, vol. 2, pp. 119.
19. Eisenach J.C., Pan P.H., Smiley R. et al. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain, 2008, vol. 140, pp. 87-94.
20. Flykt M., Kanninen K., Sinkkonen J. et al. Maternal depression and dyadic interaction: the role of maternal attachment style. Infant Child Developm., 2010, vol. 19, no. 5, pp. 530-550.
21. Green A.D., Barr A.M., Galea L.A. Role of estradiol withdrawal in «anhedonic» sucrose consumption: a model of postpartum depression. Physiol. Behav., 2009, vol. 97, no. 2, pp. 259-265.
22. Gress-Smith J.L., Luecken L.J., Lemery-Chalfant K. et al. Postpartum depression prevalence andimpact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal Child Health J., 2012, vol. 16, no. 4, pp. 887-893.
23. Halbreich U., Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J. Affect Disord., 2006, vol. 91, no. 2-3, pp. 97-111.
24. Hiltunen P., Raudaskoski T., Ebeling H. et al. Does pain relief during delivery decrease the risk of postnatal depression? Acta obstetrician et gynecologica Scandinavica: AOGS (Oxford : Wiley-Blackwell). 2004, vol. 3, pp. 83.
25. Jaeschke R., Siwek M., Dudek D. Poporodowe zaburzenia nastroju − update. Neuropsychiatria i Neuropsychologia, 2012, vol. 7, pp. 113-121.
26. Josefsson A., Berg G., Nordin C. et al. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet. Gynecol. Scand., 2001, vol. 80, no. 3, pp. 251-255.
27. Maliszewska K., Świątkowska-Freund M., Bidzan M. et al. Relationship and social support and personality as the psychosocial factors that determine the risk for postpartum blues. Ginekologia Polska, 2016, vol. 87, no. 6, pp. 442-447.
28. McDonnell N.J., Keating M.L., Muchatuta N.A. et al. Analgesia after caesarean delivery. Anaesth. Intens. Care, 2009, vol. 37, no. 4, pp. 539−551.
29. Melzack R., Katz J. Pain management in persons in pain. In: Wall PD, Melzack R, eds. Textbook of Pain. Edinburgh: Churchill Livingstone. 1999.
30. Milgrom J., Gemmill A.W., Bilszta J.L. et al. Antenatal risk factors for postnatal depression: a large prospective study. J. Affect. Disord., 2008, vol. 108, no. 1-2, pp. 147-157.
31. Miller L.J. Postpartum depression. JAMA, 2002, vol. 287, no. 6, pp. 762-765.
32. Morrell C.J., Slade P., Warner R. et al. Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: Pragmatic cluster randomised trial in primary care. BMJ, 2009, vol. 338, pp. 276-279.
33. Myers E.R., Aubuchon-Endsley N., Bastian L.A. et al. Efficacy and Safety of Screening for Postpartum Depression. Comparative Effectiveness Review 106. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I.) AHRQ Publication No. 13−EHC064−EF. Rockville, MD: Agency for Healthcare Research and Quality; April 2013. www. effectivehealthcare.ahrq.gov/reports/final.cfm.
34. Ng R.C., Hirata C.K., Yeung W. et al. Pharmacologic treatment for postpartum depression: a systematic review. Pharmacotherapy, 2010, vol. 30, no. 9, pp. 928-941.
35. O'Hara M.W., Swain A.M. Rates and risk of postpartum depression − a meta-analysis. Internation. Rev. Psychiatry, 1996, vol. 8, no. 1, pp. 37-54.
36. O’Hara M.W., McCabe J.E. Postpartum depression: Current status and future directions. Ann. Rev. Clin. Psychol., 2013, vol. 9, pp. 379-407.
37. O'Connor E.A., Whitlock E.P., Gaynes B. et al. Screening for depression in adults and older adults in primary care: an updated systematic review. Evidence Synthesis, no. 75, 2012, PMID, 20722174. www.ncbi.nlm.nih. gov/books/NBK36406/.
38. Patel R.R., Murphy D.J., Peters T.J. Operative delivery and postnatal depression: a cohort study. British Med. J., 2005, vol. 330, pp. 879.
39. Pawils S., Metzner F., Wendt C. et al. Рatients with postpartum depression in gynaecological practices in germany – results of a representative survey of local gynaecologists about diagnosis and management. Geburtsh Frauenheilk, 2016, vol. 76, pp. 888-894.
40. Pawlby S., Hay D.F., Sharp D. et al. Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community-based study. J. Affect Disord., 2009, vol. 113, pp. 236-243.
41. Pearson R.M., Evans J., Kounali D. et al. Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiatry, 2013, vol. 70, pp. 1312-1319.
42. Podolska M., Majewska A. Lęk jako stan i jako cecha w grupie kobiet, u których zakończono ciążę za pomocą cięcia cesarskiego. Kliniczna Perinatologia i Ginekologia, 2007, vol. 43, no. 4, pp. 56-60.
43. Robertson E., Grace S., Wallington T. et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen. Hosp. Psychiatry, 2004, vol. 26, no. 4, pp. 289-295.
44. Soet J.E., Brack G.A., DiIorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth, 2003, vol. 30, pp. 36-46.
45. Suda S., Segi-Nishida E., Newton S.S. et al. A postpartum model in rat: behavioral and gene expression changes induced by ovarian steroid deprivation. Biol. Psychiatry, 2008, vol. 64, no. 4, pp. 311-319.
46. Thangavelautham S., Thi P.T.P., Chen H., et al. Investigating analgesic and psychological factors associated with risk of postpartum depression development: a case-control study. Neuropsych. Dis. Treatment, 2016, vol. 12, pp. 1333-1339.
47. Ware J.E., Kosinski M., Gandek B. et al. The factor structure of the SF−36 health survey in ten countries: Results from the IQOLA project. J. Clin. Epidemiol., 1998, vol. 51, pp. 1159-1165.
48. Wisner K.L., Stika C.S., Clark C.T. Double duty: does epidural labor analgesia reduce both pain and postpartum depression? 2014, vol. 2, pp. 119, www. anesthesia-analgesia.org
49. Yoshida K., Yamashita H., Ueda M. et al. Postnatal depression in Japanese mothers and the reconsideration of «Satogaeri bunben». Pediatrics International, 2001, vol. 43, no. 2, pp. 189-193.
50. Yoshiyuki T., Tomoe K., Kenji T. et al. Antenatal risk factors of postpartum depression at 20 weeks gestation in a japanese sample: psychosocial perspectives from a cohort study in Tokyo. J. Pone, 2015, PMID: 0142410
Review
For citations:
Ryazanova O.V., Aleksandrovich Yu.S., Gorkovaya I.A., Korgozha M.A., Koshkina Yu.V., Ioskovich A.M. EFFECT OF PAIN RELIEF IN DELIVERY ON THE FREQUENCY OF POSTPARTUM DEPRESSION IN NEW MOTHERS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2017;14(1):29-35. (In Russ.) https://doi.org/10.21292/2078-5658-2017-14-1-29-35