Association between postpartum depression and anaesthesia methods in women undergoing caesarean section: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis incorporating cohort studies and randomized controlled trials
PubMed 40771157 · doi:10.1097/EJA.0000000000002252
What was done
Authors conducted a systematic review and meta-analysis searching PubMed, Embase, and Web of Science through April 16, 2025. They included randomized controlled trials and cohort studies evaluating postpartum depression outcomes in women undergoing Caesarean section with general anaesthesia compared to non-general anaesthesia. The review included 7 studies comprising 1,482,355 patients.
What was found
General anaesthesia significantly increased the risk of overall postpartum depression (OR = 1.64, 95% CI 1.23 to 2.19) and severe postpartum depression (OR = 1.41, 95% CI 1.35 to 1.47). Subgroup analysis by timing showed elevated risk for diagnosis within one year postpartum (OR = 1.22, 95% CI 1.02 to 1.46) and within seven days postpartum (OR = 4.68, 95% CI 1.21 to 18.09).
Why it matters
The findings demonstrate a significant association between anaesthetic choice for Caesarean section and subsequent maternal mental health, supporting efforts to minimise general anaesthesia exposure when feasible.
Limits
The abstract includes both RCTs and cohort studies without specifying their relative proportions, though the massive sample size indicates predominantly observational data vulnerable to confounding by indication (such as emergency status or severe obstetric complications). Additionally, the seven-day postpartum risk estimate exhibits substantial imprecision (95% CI 1.21 to 18.09), and specific non-general anaesthesia modalities are not differentiated in the abstract.
Cited by
- supports Approximately 45% to 50% of women who receive general anesthesia for a C-section develop postpartum depression, compared to roughly 28% to 30% with an epidural and 10% to 12% with unmedicated birth.