Association between neuraxial labor analgesia and postpartum depression: A meta-analysis
Abstract
Background Labor and delivery complications, particularly pain, are important risk factors for postpartum depression (PPD). Neuraxial labor analgesia can effectively relieve labor pain; however, the association between neuraxial labor analgesia and PPD, if any, has not been established. Methods PubMed, MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library were searched. The incidence of PPD was the primary outcome. The secondary outcome was the difference in postpartum Edinburgh Postpartum Depression Scale scores between the neuraxial labor analgesia and control groups. Subgroup analyses and post-hoc meta-regression were performed. Results Nineteen studies with a total of 8758 parturients were identified. Neuraxial labor analgesia did not decrease PPD risk compared to the control group (OR = 0.84, 95% CI: 0.58-1.23); however, after being stratified by PPD prevalence, neuraxial labor analgesia decreased the risk for PPD in the high prevalence (>14%) subgroup (OR = 0.61, 95% CI: 0.39-0.94) and increased the risk for PPD in the low prevalence ( Limitation Heterogeneity and a limited number of randomized controlled trials may bias the interpretation of the results. Conclusion Neuraxial labor analgesia had a protective effect when administered to parturients in the region with a high prevalence of PPD, but became a risk factor when administered to parturients in the region with a low prevalence of PPD.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Taken together, neuraxial anesthesia appears to function as a modifying factor within a multifactorial risk framework, rather than as an independent preventive or causative determinant of postpartum depression.
“Taken together, neuraxial anesthesia appears to function as a modifying factor within a multifactorial risk framework, rather than as an independent preventive or causative determinant of postpartum depression.16”
Effective pain relief through neuraxial anesthesia may reduce physiological stress responses and improve maternal satisfaction.
“Conversely, effective pain relief through neuraxial anesthesia may reduce physiological stress responses and improve maternal satisfaction.15,16”
One meta-analysis found that neuraxial analgesia was a possible risk factor for postpartum depression in a low prevalence subgroup.
“one meta-analysis found that neuraxial analgesia was a possible risk factor for PPD in a low prevalence subgroup.16,54”
Cites
Effects of perinatal mental disorders on the fetus and child
Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., Howard, L. M., & Pariante, C. M. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61277-0 · Cited by 2,166 · see citing works
Wisner, K. L., Sit, D. K. Y., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L., Eng, H. F., Luther, J. F., Wisniewski, S. R., Costantino, M. L., et al. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.87 · Cited by 1,091 · see citing works
Stewart, D. E., & Vigod, S. (2016) · New England Journal of Medicine · doi:10.1056/nejmcp1607649 · Cited by 500 · see citing works
Bauman, B. L., Ko, J. Y., Cox, S., D’Angelo, M., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6919a2 · Cited by 399 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Fagan, J., Dufour, S., Duet, S., Downs, E., Siddaiah, H., Viswanath, O., Shekoohi, S., & Kaye, A. (2026) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s579920
- Authors
- Wang, J., Zhao, G., Song, G., & Liu, J.
- Affiliations
- First Hospital of China Medical University (CN)
- Sheng Jing Hospital (CN)
- Corresponding author
- Liu, Jing
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 311
- Pages
- 95-102
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4280519203
- Cited by
- 17
- References
- 4
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 1
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- neuraxial labor analgesia, postpartum depression, labor pain, epidural analgesia, regional anesthesia, Edinburgh Postnatal Depression Scale, maternal mental health
- MeSH terms
- Analgesics, Female, Humans, Pregnancy, Prospective Studies, Analgesia, Epidural, Depression, Postpartum, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
