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Intraoperative Esketamine and Postpartum Depression Among Women With Cesarean Delivery: A Randomized Clinical Trial

Li Ren, Ting Zhang, B Zou, Xiaomei Su, Yuan Tao, Jixing Yang, Fangfang Lv, Peining Li, Fei Peng, Guodong Wu

Obstetric Anesthesia Digest November 18, 2025 DOI: 10.1097/01.aoa.0001171036.71757.fb via OpenAlex

Summary

AI-generated from the abstract

Postpartum depression affects about 17.7% of new mothers globally and 21.4% in China. Cesarean birth increases the risk of developing postpartum depression compared to vaginal birth. Esketamine, a rapid-acting antidepressant derived from ketamine, has shown mixed results in prior randomized clinical trials for preventing postpartum depression, with limited real-world evidence of its effectiveness. This study examined the practical impact of esketamine in reducing the risk of postpartum depression following cesarean delivery.

Study at a glance

Characteristics Randomized clinical trial Peer reviewed
Population New mothers who had cesarean birth
Intervention Esketamine
Keywords Postpartum depression Randomized controlled trial Incidence geometry Depression economics Clinical trial
Citations 1
Key finding Esketamine may reduce the risk of postpartum depression following cesarean birth, but prior randomized clinical trials have shown mixed results.

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.

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