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Updated: Jun 6, 2026

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Neuraxial versus General Anesthesia for Cesarean Delivery and the Risk of Postpartum Depression: A Nationwide
1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Introduction:
This study aimed to evaluate the independent association between the mode of anesthesia and the risk of postpartum depression (PPD) among mothers undergoing cesarean delivery.
Methods:
This retrospective cohort study utilized the South Korean National Health Insurance Service database for first-time cesarean deliveries (2015-2023). Anesthesia was classified as neuraxial (NA) or general (GA). The primary endpoint was newly diagnosed PPD within one year, analyzed via 1:1 propensity score matching and Cox regression. Number needed to harm (NNH), the reciprocal of absolute risk difference, indicated the number of GA exposures required for one additional PPD case.
Results:
Of the 890,801 mothers included, 555,373 (62.3%) received NA and 335,428 (37.7%) received GA. In the crude analysis, the incidence of PPD was 2.4% in the GA group and 1.9% in the NA group (hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.76-0.80;P < 0.001). After 1:1 PS matching (302,511 women in each group; n = 605,022 total), the NA group maintained a significantly lower risk of PPD compared to the GA group (2.1% vs. 2.3%; HR 0.88; 95% CI 0.85-0.91; P < 0.001), yielding an absolute risk difference of 0.28% (95% CI, 0.21%-0.36%) and a NNH of 353.
Conclusions:
NA for cesarean delivery is associated with a significantly lower risk of PPD compared to GA. Given the rising global rates of both cesarean delivery and maternal mental health disorders, prioritizing neuraxial techniques may optimize long-term maternal mental health outcomes.
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