BACKGROUND: Using labor, epidural analgesia has been linked to a reduced risk of postpartum depression, but the role of labor pain relief in this association remains unclear. The goal of this study was to test the hypothesis that effective epidural analgesia during labor is associated with reduced postpartum depression symptomatology. METHODS: A single, institutional, retrospective, observational cohort design was chosen. The primary outcome was Edinburgh postnatal depression scale (EPDS) score, measured at the 6-week postpartum visit. Subjects included in the final analysis had (1) received labor epidural analgesia; (2) pain assessed during labor both before and during initiation of labor epidural analgesia by 0–10 numeric rating scores; and (3) depression risk assessed by the EPDS and documented at their 6-week postpartum visit. Simple and multiple linear regression was used to identify the best model for assessing the association between pain improvement, defined as percent improvement in pain (PIP), and depression, after adjusting for a history of anxiety or depression, other psychiatric history, abuse, trauma, mode of delivery, and other maternal or fetal comorbid diseases. RESULTS: Two hundred one patients were included in the final analysis. Women with higher improvements in pain were associated with lower EPDS scores (r = 0.025; P = .002). Variables known to be associated with depression (body mass index, anxiety and/or depression, third- and fourth-degree perineal lacerations, and anemia) were significantly correlated with EPDS score and included in the final model. After we adjusted for these covariates, PIP remained a significant predictor of EPDS score (r = 0.49; P = .008), accounting for 6.6% of the variability in postpartum depression scores. The full model including pain, body mass index, anxiety and/or depression, perineal lacerations, and anemia explained 24% of the variability in postpartum depression scores. CONCLUSIONS: Although the extent of labor pain relief by epidural analgesia predicts lower postpartum depression scores, the relative contribution of PIP to risk for postpartum depression symptoms may be less than other established risk factors for depression. These data support that the clinical significance of labor analgesia in the development of postpartum depression needs to be more clearly defined. Accepted for publication October 30, 2017. Funding: G.L. is supported in part by the National Institutes of Health, T32GM075770 and K12HD043441. The authors declare no conflicts of interest. Institutional Review Board: This study was approved by the University of Pittsburgh Institutional Review Board (PRO15060463), 3500 5th Ave, Hieber Building, Room 106, Pittsburgh, PA 15213. E-mail: askirb@pitt.edu. This study was presented as an abstract at the annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP), May 18–22, 2016, Boston, MA, and at the annual meeting of the American Society of Anesthesiologists (ASA), October 26, 2016, Chicago, IL. Reprints will not be available from the authors. Address correspondence to Grace Lim, MD, MS, Department of Anesthesiology, Magee-Women's Hospital of the University of Pittsburgh Medical Center, 300 Halket St, Suite 3510, Pittsburgh, PA 15232. Address e-mail to limkg2@upmc.edu. © 2017 International Anesthesia Research Society
http://ift.tt/2CbMsKg
Αρχειοθήκη ιστολογίου
-
►
2020
(289)
- ► Φεβρουαρίου (28)
-
►
2019
(9071)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3642)
- ► Ιανουαρίου (3200)
-
►
2018
(39872)
- ► Δεκεμβρίου (3318)
- ► Σεπτεμβρίου (3683)
- ► Φεβρουαρίου (2693)
- ► Ιανουαρίου (3198)
-
▼
2017
(41099)
-
▼
Δεκεμβρίου
(3127)
-
▼
Δεκ 13
(426)
- Resuscitative endovascular balloon occlusion of th...
- The forgotten organ
- Sclerosing lipogranuloma presenting as movable mas...
- Early cutaneous eruptions after oral hydroxychloro...
- MRI screening of the internal auditory canal: Is g...
- Combined use of a nanocarbon suspension and 99mTc-...
- Microinvasive parathyroidectomy: Incremental impro...
- Nanoparticle delivery of RNA-based therapeutics to...
- An innovative solution for T-tube obstruction: The...
- Clinical implications of magnetic resonance imagin...
- Brain volume changes in hyposmic patients before a...
- Use of autologous adipose-derived mesenchymal stem...
- When should a level IIB neck dissection be perform...
- Effect of rural and urban geography on larynx canc...
- Trial of hyperthermic treatment for Bowen's diseas...
- Relationship between serum anti-varicella zoster v...
- Postmenopausal craniofacial hyperhidrosis
- IL-25 is involved in CTCL progression by establish...
- Regulation of MAVS activation through post-transla...
- Methotrexate and azathioprine in severe atopic der...
- Combined use of a nanocarbon suspension and 99mTc-...
- MRI screening of the internal auditory canal: Is g...
- Steroidpsychose als Folge einer regulären Hörsturz...
- Reply
- When to Stop Immunotherapy: First Response? Max Re...
- Distinctive cutaneous and systemic features associ...
- Perianal tuberculosis in an immunocompetent patient
- Epidermodysplasia verruciformis in an adult patien...
- Dermoscopy for discriminating between Trichophyton...
- Four cases of anti-Mi-2 antibody-positive dermatom...
- The Economics of Colon Cancer
- The Expanding Toolkit of Translating Ribosome Affi...
- Delayed Treatment with Histone Deacetylase Inhibit...
- Graded Elevation of c-Jun in Schwann Cells In Vivo...
- What Can Recordings in the Striatum Tell Us about ...
- FGF-FGFR Mediates the Activity-Dependent Dendritog...
- Activation of {gamma}-Secretase Trimming Activity ...
- Detailed Dendritic Excitatory/Inhibitory Balance t...
- This Week in The Journal
- The Ubiquitin E3 Ligase TRAF6 Exacerbates Ischemic...
- Neuropeptide S Activates Paraventricular Oxytocin ...
- Interlayer Repulsion of Retinal Ganglion Cell Mosa...
- Sleep in Humans Stabilizes Pattern Separation Perf...
- Morphological Constraints on Cerebellar Granule Ce...
- Multimodal Imaging in Rat Model Recapitulates Alzh...
- Working Memory and Decision-Making in a Frontopari...
- Neural Representations of Hierarchical Rule Sets: ...
- Firefighter Skin Cancer and Sun Protection Practices
- Clinical Findings and Gene Expression in Balloon C...
- Tender Nodules on the Lower Legs
- Noninvasive Gene Expression Testing in Amelanotic ...
- Hypercoagulable Conditions and Calciphylaxis in Re...
- 15,000 Cases Reports Published
- Industry Influence in Dermatology Clinical Practic...
- The Most Beautiful People
- Chronic Urticaria in Children
- December 2017
- The Epidemic of Guns
- A Transgender Woman With Anogenital Lichen Sclerosus
- Industry Payments Among Dermatology Clinical Pract...
- Factors Associated With Chronic Urticaria in Children
- Treatment of Psychiatric Disorders and Skin-Restri...
- Sclerotherapy for Reticular Veins in the Lower Limbs
- Prescription-Strength Topical Steroids Sold Withou...
- Alcohol-Related Mortality in Patients With Psoriasis
- Industry Influence in Dermatology Clinical Practic...
- The Most Beautiful People
- Chronic Urticaria in Children
- Prescription-Strength Topical Steroids Sold Withou...
- December 2017
- The Epidemic of Guns
- A Transgender Woman With Anogenital Lichen Sclerosus
- Industry Payments Among Dermatology Clinical Pract...
- Dermatology in Epic Poetry—From Beowulf to The Ody...
- Factors Associated With Chronic Urticaria in Children
- Barber Recognition of Pseudofolliculitis Barbae an...
- Diagnostic Accuracy of Pediatric Teledermatology U...
- Sclerotherapy for Reticular Veins in the Lower Limbs
- Alcohol-Related Mortality in Patients With Psoriasis
- Joseph Goldberger—Public Health Champion and Inves...
- Resilience and Depression in Patients With Hidrade...
- Stevens-Johnson Syndrome and Toxic Epidermal Necro...
- Long-term Change in the Risk of Skin Cancer After ...
- Hypophysenadenome – nicht immer benigner Natur
- Pepsin in saliva as a diagnostic biomarker in lary...
- In vivo imaging the motility of monocyte/macrophag...
- Cerebral blood flow changes after radiation therap...
- Awake mapping is not an additional surgical techni...
- Isolated and repeated stroke-like episodes in a mi...
- Predictors of post-stroke body temperature elevation
- As the first sign of multiple sclerosis, eight-and...
- PEG Hydrogel Containing Calcium-Releasing Particle...
- Clinically Advancing and Promising Polymer-based T...
- Work Outcomes in Patients Who Stay at Work Despite...
- Rational evaluation of the therapeutic effect and ...
- REAL TIME PCR TO EVALUATE HSV-2 SHEDDING FROM ANAL...
- Recovery of Hepatitis C Specific T-cell Responses ...
- Characterization of a Norovirus-specific monoclona...
- Fachärztliches Basiswissen zur Wirksamkeit von Hör...
- Longitudinal assessment of rabbit renal fibrosis i...
-
▼
Δεκ 13
(426)
- ► Σεπτεμβρίου (2173)
-
▼
Δεκεμβρίου
(3127)
-
►
2016
(13807)
- ► Δεκεμβρίου (700)
- ► Σεπτεμβρίου (600)
- ► Φεβρουαρίου (1350)
- ► Ιανουαρίου (1400)
-
►
2015
(1500)
- ► Δεκεμβρίου (1450)
Ετικέτες
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου