Effect of Single Intravenous Injection of Esketamine on Postpartum Depression after Labor Analgesia and Potential Mechanisms: A Randomized, Double-blinded Controlled Trial
Bin Ling, Yun Zhu, Zelin Yan, Hao Chen, Hua Xu, Qi Wang, Wanyou Yu, Wei Wang
Research Square June 30, 2023 preprint DOI: 10.21203/rs.3.rs-3100226/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind |
|---|---|
| Sample size | 120 |
| Population | Women who underwent labor analgesia by epidural analgesia pump |
| Interventions | Esketamine placebo |
| Dose | 0.2 mg/kg |
| Duration | Follow-up at 24 hours, 1 week, and 6 weeks after delivery |
| Topics | Depression Esketamine |
| Key findings | A single intravenous injection of esketamine after delivery reduced the incidence of postpartum depression at one week (3.4% vs 15.3%) and six weeks (5.2% vs 18.6%) compared with placebo, without increasing side effects over 48 hours. The authors suggest the antidepressant effect may be related to reduced stress response and inflammation. |
Abstract
Background: ： The study was designed to investigate effects of single intravenous injection of esketamine on the incidence of postpartum depression (PPD) after labor analgesia and explore the potential mechanisms.
Methods: ： A total of 120 women who underwent labor analgesia by epidural analgesia pump were enrolled and divided into two groups randomly. Esketamine at a dose of 0.2 mg/kg was intravenously injected after fetal disengagement in the test group and placebo was administered in the control group. The occurrence of PPD and side effects after delivery were recorded. Some indicators related to stress and inflammation were measured before labor analgesia and at 24 hours, 1 week, and 6 weeks after delivery in this study. Data were analyzed by independent t-test, repeated measures analysis of variance and Chi-square test in SPSS software (version 25.0). It was considered statistically significant since a p value less than 0.05.
Results: ： The incidence of PPD was significantly decreased both for one week and six weeks after delivery by using of esketamine (3.4% vs 15.3%, p = 0.004 and 5.2% vs 18.6%, p = 0.006, respectively) . There were also significant differences between the stress and inflammation-related indicators in different time points in this study, while the side effects for 48 hours after delivery were similar between the two groups.
Conclusions: ： Single intravenous injection of esketamine after delivery in participants underwent labor analgesia can decrease the occurrence of postpartum depression for one week and six weeks after delivery, while the side effects were not increased. The antidepressant effects of esketamine may be related to the reduction of stress response and inflammation.
Comparable studies
Other randomized controlled trials on esketamine for depression, most cited first.