Association between the effectiveness of labor epidural analgesia and postpartum depression: a prospective cohort study

Abstract

Purpose Postpartum depression (PPD) is a major health issue affecting maternal and neonatal well-being. Labor pain is a significant psychophysiological stressor, and its association with PPD is not completely understood. This study investigated the relationship between the effectiveness of labor epidural analgesia (LEA), measured as percentage improvement in pain (PIP), and the risk of PPD at six weeks postpartum. Methods In this prospective observational cohort study, 156 women were enrolled. Participants self-selected whether to receive LEA. Pain intensity was assessed using the Numerical Rating Scale, and PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) on postpartum day 3 and at six weeks postpartum. Results A moderate positive correlation was observed between LEA satisfaction and PIP (r s = 0.389, P < 0.001). A small but significant negative correlation was found between LEA satisfaction and EPDS scores (r s = - 0.268, P = 0.007). However, PIP was not significantly associated with the risk of PPD. PPD prevalence did not significantly differ between the LEA group (7.9%) and the non-LEA group (12.7%) (P = 0.491). Conclusion While the use of LEA provided effective pain relief, it was not associated with the risk of PPD. Maternal perception of pain relief may have greater psychological relevance than the objective degree of pain reduction. Comprehensive psychosocial and medical care remains essential.