Usage Of General Anesthesia In Cesarean Births Increases Incidence Of Postpartum Depression By 54 Percent
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
The research is the first to examine the effect of the mode of anesthesia
for cesarean delivery on the risk of postpartum depression
) and the possible protective effect of having regional anesthesia
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
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
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
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