Intraoperative Esketamine and Postpartum Depression Among Women With Cesarean Delivery: A Randomized Clinical Trial
Obstetric Anesthesia Digest – November 18, 2025
Source: OpenAlex
Summary
Postpartum depression affects approximately 17.7% of new mothers worldwide, soaring to 21.4% in China, with cesarean delivery linked to higher risks. In a randomized controlled trial involving new mothers, the application of esketamine—a rapid-acting antidepressant—showed promise in preventing postpartum depression after cesarean births. While previous clinical trials yielded mixed outcomes, this study aimed to assess esketamine's effectiveness in real-world settings, contributing valuable insights into maternal mental health during pregnancy and the postpartum period.
Abstract
( JAMA Network Open . 2025;8(2):e2459331. doi: 10.1001/jamanetworkopen.2024.59331) Postpartum depression (PPD) is a widespread condition affecting about 17.7% of new mothers globally, with an even higher incidence of 21.4% reported in China. Cesarean birth (CB) appears to increase the risk of developing PPD compared to vaginal births. Given the growing recognition of esketamine, a derivative of ketamine, as a rapid-acting antidepressant, its potential use in PPD prevention has become a subject of interest. While prior randomized clinical trials (RCTs) have shown mixed results, there has been limited real-world evidence of its efficacy in typical clinical settings. The objective of this study was to examine the practical impact of esketamine in reducing the risk of PPD following CB.