Postpartum depression (PPD) affects approximately 10% to 20% of women. A recent study, published in the Journal of JAMA Network Open, suggests that administering dexmedetomidine in the early postpartum period can reduce the incidence of PPD. The study found that women who experienced prenatal depression and underwent Cesarean significantly benefited from the dexmedetomidine administration, as it reduced the incidence of positive PPD.
The randomized clinical trial conducted by Zhou et al. involved 338 women with prenatal depression scheduled for elective Cesarean delivery in two hospitals in Hunan, China. Participants were randomly assigned to receive either dexmedetomidine or saline in a 1:1 ratio, infused for 10 minutes after delivery. Subsequently, sufentanil or a combination of dexmedetomidine and sufentanil was administered for 48 hours in the control and dexmedetomidine groups, respectively.
The study reported a significant decrease in the occurrence of positive PPD screening in the dexmedetomidine group at both 7 and 42 days postpartum compared to the control group. On day 7, the incidence was 12.6% in the dexmedetomidine group and 32.1% in the control group (risk ratio, 0.39). On day 42, the incidence was 11.4% in the dexmedetomidine group and 30.3% in the control group (risk ratio, 0.38). Although no significant differences in adverse events were observed between the groups, the dexmedetomidine group showed a higher incidence of hypotension (18.3% versus 9.5%; risk ratio, 2.15).
Zhou and colleagues highlighted that the preventive administration of dexmedetomidine in the early postpartum period reduced the incidence of positive PPD screening, alleviated postoperative pain, improved sleep quality, and maintained a favorable safety profile. They suggested that the antidepressant effect of dexmedetomidine might be associated with the upregulation of brain-derived neurotrophic factors and the downregulation of pro-brain-derived neurotrophic factors.
Incorporating dexmedetomidine into postpartum care for women with prenatal depression, particularly those undergoing Cesarean delivery, may contribute to a comprehensive approach in reducing the burden of postpartum depression. However, further research and replication of these findings are essential before widespread adoption of this intervention.
Reference
Zhou Y, Bai Z, Zhang W, Xu S, Feng Y, Li Q, et al. Effect of Dexmedetomidine on Postpartum Depression in Women With Prenatal Depression: A Randomized Clinical Trial. JAMA Network Open. 2024 Jan 25;7(1):e2353252.