Usage Of General Anesthesia In Cesarean Births Increases Incidence Of Postpartum Depression By 54 Percent
Source: Thailand Medical News Feb 04, 2020 4 years, 10 months, 2 weeks, 3 days, 20 hours, 39 minutes ago
A recent research study indicates that having
general anesthesia in a
cesarean delivery is linked with significantly increased odds of severe
postpartum depression requiring hospitalization, thoughts of suicide or self-inflicted injury. The findings from research conducted at Columbia University Mailman School of Public Health and Columbia University Irving Medical Center are published online in
Anesthesia and Analgesia, the journal of the International
Anesthesia Research Society.
The research is the first to examine the effect of the mode of
anesthesia for cesarean delivery on the risk of
postpartum depression (
PPD) and the possible protective effect of having regional
anesthesia for
cesarean delivery on maternal mental health compared with
general anesthesia.
It has been observed that
postpartum depression in the U.S. has increased seven-fold in the past 15 years, and it now affects up to 1 in 7 women, (globally the incidence is about 1 to 28 women) yielding about 550,000 annual new cases.
Dr Jean Guglielminotti, MD, Ph.D., in the Department of Anesthesiology and the Department of Epidemiology at Columbia Mailman School, and first author told
Thailand Medical News, "
General anesthesia for
cesarean delivery may increase the risk of
postpartum depression because it delays the initiation of mother to infant skin-to-skin interaction and breastfeeding, and often results in more acute and persistent postpartum pain. These situations are often coupled with a new mother's dissatisfaction with
anesthesia in general, and can lead to negative mental health outcomes."
The medical researchers used hospital discharge records of
cesarean delivery cases performed in New York State hospitals between 2006 and 2013. Of the 428,204
cesarean delivery cases included in the analysis, 34,356 or 8 percent of the women had
general anesthesia. Severe
postpartum depression requiring hospitalization was recorded in 1,158 women (3 percent); of which 60 percent were identified during readmission to the hospital, after approximately 164 days post-discharge. Compared to regional
anesthesia in
cesarean delivery,
general anesthesia was associated with a 54 percent increased odds of
postpartum depression. The odds increased to 91 percent for suicidal thoughts or self-inflicting injury.
Though
general anesthesia is associated with the shortest decision-to-delivery interval in case of an emergency delivery, there is no evidence that it improves outcomes for the baby but there is mounting evidence that there can be adverse conseque
nces for mothers, noted Dr. Guglielminotti.
Co-author Dr Guohua Li, MD, DrPH, Finster Professor of Epidemiology and Anesthesiology told Thailand
Medical News, "Our findings underscore the need to avoid using
general anesthesia for
cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to
general anesthesia,"
Reference
: Anesthesia and Analgesia,
DOI: 10.1213/ANE.0000000000004663 , https://journals.lww.com/anesthesia-analgesia/Abstract/publishahead/Exposure_to_General_Anesthesia_for_Cesarean.95799.aspx
