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Use of General Anesthesia May Up Risk for Postpartum Depression

PPD requiring hospitalization higher among women undergoing general anesthesia for cesarean delivery

TUESDAY, Feb. 11, 2020 (HealthDay News) — General anesthesia for cesarean delivery is associated with increased odds of severe postpartum depression (PPD), suicidal ideation, and self-inflicted injury, according to a study published online Jan. 29 in Anesthesia & Analgesia.

Jean Guglielminotti, M.D., Ph.D., and Guohua Li, M.D., Dr.P.H., both from Columbia University in New York City, retrospectively reviewed cesarean delivery cases performed in New York State hospitals from 2006 through 2013 to assess if general anesthesia is associated with increased odds of severe postpartum depression versus neuraxial anesthesia.

The researchers identified 428,204 cesarean delivery cases, including 34,356 women who received general anesthesia (8 percent). Severe PPD requiring hospitalization occurred in 1,158 women (2.7 per 1,000) a median of 164 days after discharge. General anesthesia in cesarean delivery was associated with increased odds of PPD (adjusted odds ratio [aOR], 1.54; 95 percent confidence interval [CI], 1.21 to 1.95) and increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95 percent CI, 1.12 to 3.25) versus neuraxial anesthesia. However, general anesthesia was not associated with anxiety disorders (aOR, 1.37; 95 percent CI, 0.97 to 1.95) or posttraumatic stress disorder (aOR, 1.50; 95 percent CI, 0.50 to 4.47).

“If confirmed, these preliminary findings underscore the need to avoid the use of 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,” the authors write.

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