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Cited by 27Maternal Mental Health During Pregnancy and PostpartumAnesthesia and Pain ManagementMaternal and Perinatal Health Interventions

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

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Du, Weijia, Bo, Lulong, Xu, Zhendong, Liu, Zhiqiang·2022·Journal of Pain Research
DOI 10.2147/jpr.s379580PMC PMC9519391
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Abstract

Pregnancy and childbirth are major life events for women and their families, characterized by physical, psychological, and emotional changes that can trigger anxiety, depression, and mental disorders in susceptible individuals. Acute labor pain is an independent risk factor for persistent pain in the postpartum period and is associated with depressive disorders. Epidural analgesia is a well-established technique that has commonly been regarded as the gold standard in pain management during labor. Although the relationships between labor pain, labor epidural analgesia, and postpartum depression have been studied by many investigators, the results of these studies are conflicting. Some literature suggest that labor epidural analgesia is associated with a reduction in the incidence of postpartum depression; however, other studies have failed to demonstrate this association. Unmet analgesic needs expectations, unmet birth expectations, and/or the quality of social support during labor may contribute to postpartum depression. The limitations of the published studies included differential misclassification of study variables and residual confounding, variations in the diagnosis of depression, and incomplete history data. Thus, future studies should include information on sociodemographic and patient-level variables and assessments of pain during labor or in the postpartum period. Better management of labor pain should be provided to prevent long-term morbidity and improve maternal and neonatal outcomes. Anesthesiologists could collaboratively work with obstetricians and perinatal psychiatrists to ensure that hospitals prioritize screening and treatment for postpartum depression.

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  • Reduction of severe intrapartum pain and improvement in perceived control and childbirth satisfaction are recognized contributors to postpartum psychological well-being and may mitigate known risk factors for postpartum depression, such as traumatic birth experiences and poorly controlled labor pain.

    “The reduction of severe intrapartum pain, and improvement in perceived control and childbirth satisfaction are recognized contributors to postpartum psychological well-being and may mitigate known risk factors for PPD, such as traumatic birth experiences and poorly controlled labor pain.4,52”

    From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [52]

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Cited by

Sorted by citations

Authors
Du, W., Bo, L., Xu, Z., & Liu, Z.
Affiliations
  • Tongji University (CN)
  • Second Military Medical University (CN)
Corresponding author
Liu, Zhiqiang
ORCID
Venue
Journal of Pain Research
Publisher
Informa UK Limited
Published
2022-09
Volume
Volume 15
Pages
3007-3015
ISSN
1178-7090 (ISSN-L)
DOI
10.2147/jpr.s379580
PMC
PMC9519391
OpenAlex
W4296887758
Cited by
27
References
9
Citations by year
2026: 7 · 2025: 8 · 2024: 3 · 2023: 9
FWCI
0.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain Research (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Funders
  • National Natural Science Foundation of China (81971418)
  • Science and Technology Commission of Shanghai Municipality
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
labor pain, labor epidural analgesia, postpartum depression, postpartum pain, childbirth expectations, residual confounding, maternal mental health, perinatal psychiatry

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