Prophylactic esketamine for postpartum depression after cesarean section: a systematic review and meta-analysis.
Journal of affective disorders June 10, 2025 Haibin Shi, Caihong Zheng, Bin Zhu 5 citations
A meta-analysis of 13 studies with 2,716 patients found that perioperative esketamine lowers the risk of postpartum depression and reduces Edinburgh Postnatal Depression Scale scores at 1 and 6 weeks after cesarean section, and decreases pain scores within 48 hours during movement and 24 hours at rest. However, esketamine increases adverse effects such as hallucinations, dizziness, blurred vision, and diplopia. Prenatal body mass index is inversely correlated with mood response to esketamine one week after surgery. The studies had clinical heterogeneity, used different EPDS thresholds for diagnosing postpartum depression, and lacked racial diversity.