Esketamine reduces the risk of postpartum depression in women undergoing cesarean section: A systematic review and meta-analysis.
Lőrinc Frivaldszky, Kincső Lőrincz, Jakub Hoferica, Péter Hegyi, Nándor Ács, Zsolt Melczer, Péter Fehérvári, Márton Keszthelyi
Journal of Psychiatric Research March 1, 2025 DOI: 10.1016/j.jpsychires.2025.02.021 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Population | Women undergoing cesarean section |
| Intervention | Esketamine |
| Topics | Esketamine Depression |
| Keywords | Postpartum depression ppd Postnatal depression Cesarean section c-section Caesarean delivery Esketamine ketamine therapy Ketamine treatment Maternal mental health Preventive medicine |
| Citations | 4 |
| Key findings | Perioperative esketamine administration was associated with lower rates of postpartum depression and lower EPDS scores compared to placebo or standard care. |
Abstract
Postpartum depression (PPD) is a prevalent and debilitating disorder that occurs in 14% of women after giving birth. We aimed to assess the efficacy and safety of perioperative esketamine for preventing PPD in women undergoing cesarean section. We performed a systematic literature search in five medical databases - MEDLINE, Cochrane Library, Embase, Scopus, and Web of Science on the 12th of January 2025. We searched for trials on the efficacy and safety of esketamine for preventing PPD. We collected data on rates of PPD, Edinburgh Postnatal Depression Scale (EPDS) scores, and adverse effects. Pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model. Our systematic search provided 2681 records; we screened 1336 duplicate-free records. A total of 17 eligible studies were identified after title, abstract, and full-text selection. Esketamine administration was associated with a lower rate of PPD at postpartum days 3-7 and 28-42 (OR = 0.43; 95% CI: 0.31-0.59 and OR = 0.59; 95% CI: 0.39-0.87, respectively). Esketamine administration was associated with significantly lower EPDS scores at postpartum days 3-7 (MD = -1.32; 95% CI: 1.84 to -0.80). Our findings suggest that perioperative administration of esketamine was associated with lower PPD rates and lower scores on the EPDS questionnaire and was considered safe compared to placebo/standard care.