Effects Of Epidural Analgesia During The Whole Labor On Perinatal Outcomes And Postpartum Depression During Labor

Objective:To investigate the effect of epidural analgesia during Labor on perinatal outcome and occurrence of postpartum depressionMethods:?The data of 431 single term primipara and their children who were treated in LiYang People's Hospital from January 2019 to December 2019 were collected and analyzed prospectively.? The Labor analgesia needs of eligible primipara will be randomized according to inclusion/exclusion and whether epidural Analgesia is chosen or not,there were 2 groups:Natural Labor Group(Control Group)and epidural Labor analgesia group(Study Group).?Maternity:To collect General Information and questionnaires from two groups of women;To collect the scores of ZUNG depression scale(SDS),ENRICH marital satisfaction(EMS),Edinburgh Postnatal Depression scale(EPDS),3 days after delivery and 42 days after delivery;To collect the NRS scores of two groups of parturients at 2?3 cm,5?6cm,10 cm,baby's head is delivered and 2 hours postpartum;Newborn:two groups of parturients were collected after delivery of newborn sex,birth weight,whether there is Asphyxia,admission to neonatal ward after birth.?SPSS23.0 statistical software was chosen as the data processing tool,and the difference was statistically significant when using Excel to statistic the related index data(p<0.05).An EPDS score of more than 10 at 6 weeks postpartum was used as a postpartum depression indicator.To collect the perinatal variables and the characteristic information of the parturient.Multiple Logistic regression analysis was used to evaluate the relationship between the use of epidural analgesia and the incidence of postpartum depression.Result:?There were no significant differences in age,gestational age,BMI before pregnancy,marital income,satisfaction with living conditions.Any medical complications,previous adverse pregnancy and delivery history,attendance rate of school for pregnant women,complication of gynecological diseases,planning of pregnancy,history of operation,anemia before delivery,anxiety about delivery,education,prepregnancy menstrual syndrome and SDS scores before delivery(p>0.05).?The NRS scores of parturients in the study group were significantly lower than those in the control group(p<0.05)after using epidural analgesia.The NRS scores of parturients in the study group were significantly lower than those in the control group(p<0.05).?The side effects of epidural analgesia during Labor were low,and there was no significant difference in the sex,birth weight,asphyxia rate and the rate of admission to neonatal ward between the two groups(p>0.05).?There was no significant difference in EPDS score and breast feeding rate(p>0.05),comfort satisfaction and EMS score of marital satisfaction(p<0.05).?The incidence of Postpartum Depression in the study group was lower than that in the control group(15.5%&29.0%),and the breast feeding rate was higher than that in the control group(81.0%&47.5%)(p<0.05).?Univariate analysis of postpartum depression at 42 Days:When Postpartum Depression at 42 days was the dependent variable,univariate analysis showed that there were 8 significant factors in the maternal and neonatal variables recorded,and there were significant differences between the two groups,there was a significant difference in the occurrence of postpartum depression(p<0.05).These factors were:Labor Analgesia,satisfaction with marriage,continued breastfeeding after delivery,hospitalization after birth,degree of worry about delivery,high EPDS score at 3 days after delivery,attending a school for pregnant women,premenstrual syndrome.?Logistic Regression analysis of multiple factors of postpartum depression at 42 days:Epidural Labor Analgesia(regression coefficient-0.985,p 0.029,OR 0.373,95%CI,0.154-0.906).Multiple Logistic Regression analysis showed that there were 3 independent protective factors of postpartum depression:Labor Analgesia,EMS score,and breast feeding rate at 42 days postpartum.There were 4 risk factors(OR>1):Premenstrual Syndrome,worry about delivery,hospitalization after birth,and EPDS score at 3 days after delivery.ConclusionsThe use of epidural analgesia throughout Labor is one of the most important ways to reduce the psychosocial effects of postpartum depression and reduce the incidence of postpartum depression.Epidural anesthesia can effectively improve the quality of obstetrics without changing the perinatal outcome,improve the comfort and satisfaction of the Parturient,and reduce the occurrence of postpartum depression.