Esketamine reduces the risk of postpartum depression in women undergoing cesarean section: A systematic review and meta-analysis.
Journal of psychiatric research – March 01, 2025
Source: PubMed
Summary
A promising breakthrough shows that esketamine, administered during cesarean sections, can cut postpartum depression risk nearly in half. This medication, given during surgery, significantly reduced depression symptoms in new mothers both immediately after birth and up to 6 weeks postpartum. The treatment proved safe and effective, offering new hope for preventing postpartum mental health challenges.
Abstract
Postpartum depression (PPD) is a prevalent and debilitating disorder that occurs in 14% of women after giving birth. We aimed to assess the efficacy and safety of perioperative esketamine for preventing PPD in women undergoing cesarean section. We performed a systematic literature search in five medical databases - MEDLINE, Cochrane Library, Embase, Scopus, and Web of Science on the 12th of January 2025. We searched for trials on the efficacy and safety of esketamine for preventing PPD. We collected data on rates of PPD, Edinburgh Postnatal Depression Scale (EPDS) scores, and adverse effects. Pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model. Our systematic search provided 2681 records; we screened 1336 duplicate-free records. A total of 17 eligible studies were identified after title, abstract, and full-text selection. Esketamine administration was associated with a lower rate of PPD at postpartum days 3-7 and 28-42 (OR = 0.43; 95% CI: 0.31-0.59 and OR = 0.59; 95% CI: 0.39-0.87, respectively). Esketamine administration was associated with significantly lower EPDS scores at postpartum days 3-7 (MD = -1.32; 95% CI: 1.84 to -0.80). Our findings suggest that perioperative administration of esketamine was associated with lower PPD rates and lower scores on the EPDS questionnaire and was considered safe compared to placebo/standard care.