Impact of Neuraxial Labor Analgesia on the Incidence of Postpartum Depression: a Prospective, Observational, Multicenter Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 599
- 主要终点
- The incidence of postpartum depression
研究概览
简要总结
Postpartum depression (PPD) affects approximately 15% of women during the first year after giving birth, and is common across cultures. The etiology of postpartum depression is not totally clear. The severe pain experienced during childbirth was reported to be associated with the development of postpartum depression. The purpose of the present study is to evaluate whether use of neuraxial labor analgesia can reduce the incidence of postpartum depression.
详细描述
Postpartum depression (PPD) affects approximately 15% of women during the first year after giving birth, and is common across cultures. In postpartum Chinese women, the reported incidence ranged from 6.5% to 29.5%.
The etiology of postpartum depression is not totally clear. Identified risk factors include previous maternal blues, unplanned pregnancy, lack of marital or social support, and previous psychiatric illnesses. Furthermore, the severe pain experienced during childbirth was reported to be associated with the occurrence of postpartum depression.
A recent study of the investigators found that use of epidural analgesia during labor was associated with decreased risk of postpartum depression. However, several limitations existed in that study and further evidence is needed to reconfirm the finding. The purpose of the present study is to reevaluate whether use of neuraxial labor analgesia can reduce the incidence of postpartum depression.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 34 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Primiparae between 18 and 34 years of age with term single cephalic pregnancy;
- •Admitted to the delivery room during daytime working hours (from 8 am to 5 pm).
- •Preparing to deliver vaginally.
排除标准
- •History of psychiatric disease (indicate those that are diagnosed before or during pregnancy by psychiatrists);
- •Presence of contraindications to epidural analgesia, which includes: (1) History of infectious disease of the central nervous system (poliomyelitis, cerebrospinal meningitis, encephalitis, etc.); (2) History of spinal or intra-spinal disease (trauma or surgery of spinal column, intra-spinal canal mass, etc.); (3) Systemic infection (sepsis); (4) Skin or soft tissue infection at the site of epidural puncture; (5) Coagulopathy.
- •Other reasons that are considered unsuitable for study participation.
结局指标
主要结局
The incidence of postpartum depression
时间窗: At 42 days after delivery
Postpartum depression will be defined by a score of 10 or more on the Edinburgh Postnatal Depression Scale.
次要结局
- Status of baby feeding(At 24 hours and 42 days after delivery)
- Persistent pain(At 42 days after delivery)
- Neonatal Apgar score(At 1 and 5 minutes after delivery)
- The mode of delivery(At the time of delivery)
- Severity of pain(At 24 hours and 42 days after delivery)
- Persistent pain affecting daily life(At 42 days after delivery)
研究者
Dong-Xin Wang
Professor and Chairman, Department of Anesthesiology and Critical Care Medicine
Peking University First Hospital