HealthDay News — General anesthesia for cesarean delivery is associated with increased odds of severe postpartum depression (PPD), suicidal ideation, and self-inflicted injury, according to a study published in Anesthesia & Analgesia.
Jean Guglielminotti, MD, PhD, and Guohua Li, MD, DrPH, both from Columbia University in New York City, retrospectively reviewed cesarean delivery cases performed in New York State hospitals from 2006 through 2013 to assess if general anesthesia is associated with increased odds of severe postpartum depression vs neuraxial anesthesia.
The researchers identified 428,204 cesarean delivery cases, including 34,356 women who received general anesthesia (8%). Severe PPD requiring hospitalization occurred in 1158 women (2.7 per 1000) a median of 164 days after discharge. General anesthesia in cesarean delivery was associated with increased odds of PPD (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.21 to 1.95) and increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95% CI, 1.12 to 3.25) vs neuraxial anesthesia. However, general anesthesia was not associated with anxiety disorders (aOR, 1.37; 95% CI, 0.97 to 1.95) or posttraumatic stress disorder (aOR, 1.50; 95% CI, 0.50 to 4.47).
“If confirmed, these preliminary findings underscore the need to avoid the use of general anesthesia for cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to general anesthesia,” the authors write.