Labor epidural analgesia and the risk of postpartum depression: A meta-analysis of observational studies

Abstract Study objective This study aims to systematically review the literature to evaluate the association between labor epidural analgesia (LEA) and postpartum depression (PPD). Design Meta-analysis. Setting Obstetric patients delivering vaginally with or without LEA in a hospital. Interventions This study aimed to investigate the effects of providing LEA on developing PPD. Measurements Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using the random effects model. Results A total of 356 full text articles were reviewed. Eleven articles studying 85,928 patients met inclusion criteria. The pooled unadjusted OR 1.03 and 95% CI (0.77, 1.37) suggest that LEA is not associated with a decreased risk of developing PPD. Conclusions Labor epidural analgesia was not shown to confer protection against developing PPD according to this meta-analysis. Future studies are needed to explore whether other aspects of LEA, beyond its presence or absence, influence the onset of PPD.