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SAN FRANCISCO – Although birth pain has been linked to postpartum depression, the culprit may be the pain felt by the mother after delivery, rather than during the labor and delivery process. , suggests a new research presented at the annual ANESTHESIOLOGY® 2018 meeting.
Previous research has shown that the pain associated with childbirth may increase the risk of postpartum depression, but it has not specified which part of the work process (for example, before, during or after delivery) could to be at the root of the problem. This is the first study to differentiate postpartum pain from labor and childbirth pain and to identify it as a significant risk factor for postpartum depression.
"For many years, we were concerned about how to manage the pain of work, but the pain of recovery after work and delivery is often overlooked," said Jie Zhou, MD, MBA, lead author of the study and assistant professor of anesthesia at Brigham and Women's. Harvard Hospital and School of Medicine, Boston. "Our research suggests that we need to focus more on helping new mothers manage pain after the baby is born."
The symptoms of postpartum depression (extreme sadness, lack of energy, anxiety, crying, irritability and changes in sleep or eating habits) affect about 1 in 9 women, according to the Center for Control and Prevention diseases (CDC). Postpartum depression can result in decreased breastfeeding rates and poor bonding with the baby.
As part of this study, Dr. Zhou's research group examined pain scores (from the start of work on discharge from hospital) of 4,327 new mothers who gave birth to only one child per year. vaginal or caesarean section at the Brigham and Women's Hospital, June 1. , 2015 and December 31, 2017. They compared pain scores to mothers' postpartum depression scale (EPDS) scores in Edinburgh one week after delivery.
Dr. Zhou found that postpartum depression was significantly associated with higher postpartum pain scores. Mothers with postpartum depression had more pain complaints during their convalescence and often needed additional pain medications. Women in the postpartum depression group were more likely to have delivered by caesarean section. They also had more reports of inadequate postpartum pain control.
A number of factors can contribute to postpartum depression. The researchers determined that postpartum depression was higher in overweight or obese women; who was suffering from a torn perineum (the area adjacent to the vaginal opening); who had a history of depression, anxiety or chronic pain; and whose babies were smaller and had lower Apgar scores, a scoring system used to assess the physical health of newborns one minute and five minutes after birth.
"Although ibuprofen and analog analgesics are considered adequate for pain control after delivery, some women clearly need additional help to manage pain," said the Dr. Zhou "We need to better identify those at risk of postpartum pain and ensure that they receive adequate postpartum care."
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