Labor epidural analgesia and the risk of postpartum depression: A meta-analysis of observational studies.

STUDY OBJECTIVE: This study aims to systematically review the literature to evaluate the association between labor epidural analgesia (LEA) and postpartum depression (PPD). DESIGN: Meta-analysis. SETTING: Obstetric patients delivering vaginally with or without LEA in a hospital. INTERVENTIONS: This study aimed to investigate the effects of providing LEA on developing PPD. MEASUREMENTS: Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using the random effects model. RESULTS: A total of 356 full text articles were reviewed. Eleven articles studying 85,928 patients met inclusion criteria. The pooled unadjusted OR 1.03 and 95% CI (0.77, 1.37) suggest that LEA is not associated with a decreased risk of developing PPD. CONCLUSIONS: Labor epidural analgesia was not shown to confer protection against developing PPD according to this meta-analysis. Future studies are needed to explore whether other aspects of LEA, beyond its presence or absence, influence the onset of PPD.

Duke Scholars

Author Melissa Bauer Anesthesiology, Women's

Author Samuel T Bauer Obstetrics and Gynecology, Maternal Fetal Medicine