Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study

Carolyn Li-Jen Chan,1,* Chin Wen Tan,1,2,* Jason Ju In Chan,1 Rehena Sultana,3 Tze-Ern Chua,4,5 Helen Yu Chen,4,5 Alex Tiong Heng Sia,1,2 Ban Leong Sng1,2 1Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore; 2Anesthesiology and Perioperative...

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Autores principales:	Chan CLJ, Tan CW, Chan JJI, Sultana R, Chua TE, Chen HY, Sia ATH, Sng BL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	pain central sensitization anxiety anticipated pain medication needs Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/152bf02c76d1476c886c515146007c0d
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spelling	oai:doaj.org-article:152bf02c76d1476c886c515146007c0d2021-12-02T12:13:16ZFactors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study1178-2021https://doaj.org/article/152bf02c76d1476c886c515146007c0d2020-03-01T00:00:00Zhttps://www.dovepress.com/factors-associated-with-the-development-of-postnatal-depression-after--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Carolyn Li-Jen Chan,1,* Chin Wen Tan,1,2,* Jason Ju In Chan,1 Rehena Sultana,3 Tze-Ern Chua,4,5 Helen Yu Chen,4,5 Alex Tiong Heng Sia,1,2 Ban Leong Sng1,2 1Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore; 2Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; 3Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; 4Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore; 5Pediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore*These authors contributed equally to this workCorrespondence: Ban Leong Sng Tel +65 6394 1081Fax +65 62912661Email sng.ban.leong@singhealth.com.sgPurpose: Pre-operative association factors (pain and psychological vulnerability) could significantly contribute to post-Cesarean pain; however, limited information is available on the development of postnatal depression (PND). We aimed to investigate the development of PND and its association with pain vulnerability and psychological vulnerability factors.Patients and Methods: Women undergoing Cesarean delivery under spinal anesthesia were given pre-operative questionnaires, psychological and pain assessments including pain on local anesthetic injection during spinal anesthesia and mechanical temporal summation. Post-operative assessments were administered at 6 to 10 weeks post-Cesarean delivery via follow-up survey to assess post-Cesarean psychological and pain outcomes.Results: PND occurred in 21.1% (43 of 205) of patients who underwent elective Cesarean delivery. An increased pre-operative pain score with movement (Odds ratio (OR) 1.65, 95% CI 1.12– 2.44, p = 0.0110), anxiety about upcoming surgery (OR 1.02, 95% CI 1.00– 1.04, p = 0.0429), higher pre-operative Hospital Anxiety and Depression Scale (HADS) subscale on anxiety (OR 1.25, 95% CI 1.07– 1.45, p = 0.0041) and higher pre-operative central sensitization inventory (CSI) scores (OR 1.05, 95% CI 1.01– 1.09, p = 0.0156) were independently associated with an increased risk of PND. Anticipated pain medication needs were associated with reduced risk of PND (OR 0.48, 95% CI 0.29– 0.79, p = 0.0038) (Receiver operating characteristic (ROC) = 0.8177).Conclusion: Higher pre-operative anxiety, pain score, central sensitization and lower anticipated pain medication needs were associated with increased risks of PND. Further work using larger sample size will be needed to validate the model in predicting PND development after Cesarean delivery.Keywords: pain, central sensitization, anxiety, anticipated pain medication needsChan CLJTan CWChan JJISultana RChua TEChen HYSia ATHSng BLDove Medical Pressarticlepaincentral sensitizationanxietyanticipated pain medication needsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 715-727 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	pain central sensitization anxiety anticipated pain medication needs Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	pain central sensitization anxiety anticipated pain medication needs Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chan CLJ Tan CW Chan JJI Sultana R Chua TE Chen HY Sia ATH Sng BL Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
description	Carolyn Li-Jen Chan,1,* Chin Wen Tan,1,2,* Jason Ju In Chan,1 Rehena Sultana,3 Tze-Ern Chua,4,5 Helen Yu Chen,4,5 Alex Tiong Heng Sia,1,2 Ban Leong Sng1,2 1Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore; 2Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; 3Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; 4Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore; 5Pediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore*These authors contributed equally to this workCorrespondence: Ban Leong Sng Tel +65 6394 1081Fax +65 62912661Email sng.ban.leong@singhealth.com.sgPurpose: Pre-operative association factors (pain and psychological vulnerability) could significantly contribute to post-Cesarean pain; however, limited information is available on the development of postnatal depression (PND). We aimed to investigate the development of PND and its association with pain vulnerability and psychological vulnerability factors.Patients and Methods: Women undergoing Cesarean delivery under spinal anesthesia were given pre-operative questionnaires, psychological and pain assessments including pain on local anesthetic injection during spinal anesthesia and mechanical temporal summation. Post-operative assessments were administered at 6 to 10 weeks post-Cesarean delivery via follow-up survey to assess post-Cesarean psychological and pain outcomes.Results: PND occurred in 21.1% (43 of 205) of patients who underwent elective Cesarean delivery. An increased pre-operative pain score with movement (Odds ratio (OR) 1.65, 95% CI 1.12– 2.44, p = 0.0110), anxiety about upcoming surgery (OR 1.02, 95% CI 1.00– 1.04, p = 0.0429), higher pre-operative Hospital Anxiety and Depression Scale (HADS) subscale on anxiety (OR 1.25, 95% CI 1.07– 1.45, p = 0.0041) and higher pre-operative central sensitization inventory (CSI) scores (OR 1.05, 95% CI 1.01– 1.09, p = 0.0156) were independently associated with an increased risk of PND. Anticipated pain medication needs were associated with reduced risk of PND (OR 0.48, 95% CI 0.29– 0.79, p = 0.0038) (Receiver operating characteristic (ROC) = 0.8177).Conclusion: Higher pre-operative anxiety, pain score, central sensitization and lower anticipated pain medication needs were associated with increased risks of PND. Further work using larger sample size will be needed to validate the model in predicting PND development after Cesarean delivery.Keywords: pain, central sensitization, anxiety, anticipated pain medication needs
format	article
author	Chan CLJ Tan CW Chan JJI Sultana R Chua TE Chen HY Sia ATH Sng BL
author_facet	Chan CLJ Tan CW Chan JJI Sultana R Chua TE Chen HY Sia ATH Sng BL
author_sort	Chan CLJ
title	Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
title_short	Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
title_full	Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
title_fullStr	Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
title_full_unstemmed	Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study
title_sort	factors associated with the development of postnatal depression after cesarean delivery: a prospective study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/152bf02c76d1476c886c515146007c0d
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Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study

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