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Pharmacologic labour analgesia and its relationship to postpartum psychiatric disorders: a scoping review

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ARTICLE DOWNLOAD

Pharmacologic labour analgesia and its relationship to postpartum psychiatric disorders: a scoping review

10$

Allana Munro BSc, Pharm, MD, FRCPC, Hilary MacCormick MD, FRCPC, Atul Sabharwal BSc & Ronald B. George MD, FRCPC 

Abstract

Purpose

This scoping review aimed to summarize the current literature on postpartum psychiatric disorders (e.g., postpartum depression, postpartum anxiety, postpartum post-traumatic stress disorder) and the possible relationship of these disorders to the use of pharmacologic labour analgesia (e.g., epidural analgesia, nitrous oxide, parenteral opioids) to identify knowledge gaps that may aid in the planning of future research.

Sources

PubMed, PsycINFO, CINAHL, and EMBASE were searched from inception to November 9, 2018 for studies that included both labour analgesia and the postpartum psychiatric disorders specified above.

Principal findings

Two reviewers assessed the studies and extracted the data. Of the 990 identified citations, 17 studies were included for analysis. Existing studies have small sample sizes and are observational cohorts in design. Patient psychiatric risk factors, method of delivery, and type of labour analgesia received were inconsistent among studies. Most studies relied on screening tests for diagnosing postpartum psychiatric illness and did not assess the impact of labour analgesia on postpartum psychiatric illness as the primary study objective.

Conclusions

Future studies should correlate screen-positive findings with clinical diagnosis; consider adjusting the timing of screening to include the antepartum period, early postpartum, and late postpartum periods; and consider the degree of labour pain relief and the specific pharmacologic labour analgesia used when evaluating postpartum psychiatric disorders.

Only units of this product remain
Year 2020
Language English
Format PDF
DOI 10.1007/s12630-020-01587-7