Expectations, Labor Analgesia, Postpartum Depression (PPD)
Conditions
Keywords
postpartum depression, labor analgesia, epidural, expectations
Brief summary
Postpartum Depression (PPD) is defined as the development of depression at any time during the first year after childbirth¹. Its prevalence ranges from 15% to 20%. It can manifest with symptoms such as depressed mood, loss of interest and energy, insomnia, anxiety, and may even lead to suicidal ideation. The consequences are numerous, both physical and psychological, with long-term repercussions on the mother-infant bond, family dysfunction, and the development of emotional and cognitive disorders in children. The etiology of PPD is multifactorial, but numerous recent studies have focused on the role of labor pain and its management with labor analgesia techniques. The aim of the present study is therefore to assess whether there is a difference in the incidence of PPD between parturients whose expectations regarding labor analgesia were met ('expectations met' group) versus those whose expectations were unmet.
Interventions
PROCEDUREEpidural analgesia
Analgesia via epidural catheter using local anesthetic ± opioid, administered on patient request during labor.
PROCEDURESpinal analgesia for labour pain
Single-shot spinal analgesia
OTHERNo neuraxial analgesia
Patients did not received spinal or epidural labour analgesia
Sponsors
University of Padova
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Signed informed consent * Planned vaginal delivery (spontaneous or induced) * Pregnancy * Age \> 18 years
Exclusion criteria
* Allergy to local anesthetics * Language barrier * Contraindications to labor analgesia * Delivery by Cesarean section * Known history of psychiatric disorders (including major depression)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| incidence of postpartum depression | 6 months since labour | To assess whether there is a statistically significant difference in the incidence of postpartum depression (PPD), defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 at 6 months postpartum, between parturients whose expectations regarding labor analgesia were met ('expectations met' group) versus those whose expectations were unmet. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Early depressive symptoms | from 24 to 48 hours since labour | To assess whether there is a statistically significant difference in the incidence of postpartum depression (PPD), defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 at 6 months postpartum, between parturients whose expectations regarding labor analgesia were met ('expectations met' group) versus those whose expectations were unmet. |
| Effect of Analgesia Within Expectations-Unmet Group | six months since labour | To compare the incidence of postpartum depression (EPDS ≥ 10 at 6 months) within the "Expectations unmet" group, stratified by actual receipt of neuraxial labor analgesia (epidural or spinal) versus no neuraxial analgesia |
| Pain Intensity and Maternal Expectations | At delivery/birth | To assess the association between intrapartum pain intensity (measured by Visual Analog Scale, VAS) and group allocation ("Expectations met" vs "Expectations unmet"). |
Countries
Italy
Contacts
CONTACTFabrizia Calabrese, MD
CONTACTGiulia Faccioli, MD
Outcome results
None listed