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Member Research and Reports

Columbia: General Anesthesia in Cesarean Deliveries Increases the Odds of Postpartum Depression by More than 50 Percent

A new study shows 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 Columbia University Mailman School of Public Health research is published in Anesthesia and Analgesia.

The study 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 regional anesthesia for cesarean delivery on maternal mental health.

“General anesthesia for cesarean delivery may increase 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 postpartum pain,” said Dr. Jean Guglielminotti of Columbia Mailman School, and first author. “These situations are often coupled with a new mother’s dissatisfaction with anesthesia in general, and can lead to negative mental health outcomes.

The researchers used hospital discharge records of cesarean deliveries performed in NY State between 2006 and 2013. Of 428,204 cases, 8 percent had general anesthesia. Severe postpartum depression requiring hospitalization was recorded in 1,158 women (3 percent); of which 60 percent were identified during hospital readmission. General anesthesia was associated with a 54 percent increased odds of postpartum depression and increased to 91 percent for suicidal thoughts or self injury.

“Our findings underscore the need to avoid using general anesthesia for cesarean delivery when possible, and to provide mental health screening and counseling to obstetric patients exposed to general anesthesia,” said co-author Dr. Guohua Li, professor of epidemiology and anesthesiology.

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