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Single bolus low-dose of ketamine does not prevent postpartum depression: a randomized, double-blind, placebo-controlled, prospective clinical trial

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Postpartum depression is a common complication of childbirth. In the last decade, it has been suggested that subdissociative-dose ketamine is a fast-acting antidepressant. We aimed to investigate the efficacy of low-dose ketamine administered during caesarean section in preventing postpartum depression.

Methods

Using a randomized, double-blind, placebo-controlled design, 330 parturients who were scheduled to undergo caesarean section were enrolled in this trial. The parturients were randomly assigned to receive intravenous ketamine (0.25 mg/kg diluted to 10 mL with 0.9% saline) or placebo (10 mL of 0.9% saline) within 5 min following clamping of the neonatal umbilical cord. The primary outcome was the degree of depression, which was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) (a threshold of 9/10 was used) at 3 days and 6 weeks after delivery. The secondary outcome was the numeric rating scale score of pain at 3 day and 6 week postpartum.

Results

No significant differences were found in the prevalence of postpartum depression between the two groups at 3 days and 6 weeks after delivery. The pain scores measured at 3 days postoperatively were not significantly different between the groups, whereas the scores measured at 6 week postpartum were significantly reduced in the treatment group compared with the saline group (P = 0.014).

Conclusions

Intra-operative low-dose ketamine (0.25 mg/kg) does not have a preventive effect on postpartum depression.

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Acknowledgements

We extend our appreciation to Yun Yang for statistical support.

Authors' contribution

YX: Project development, Data collection, Manuscript writing. YTL: Project development. XL Huang: Project development. DLC: Random allocation sequence generation BZS: Data collection. DQM: Manuscript writing

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China

    Yang Xu, Yuantao Li, Xiaolei Huang, Daili Chen & Baozuan She

  2. Section of Anaesthetics, Pain Medicine & Intensive Care, Department of Surgery & Cancer, Faculty of Medicine, Chelsea & Westminster Hospital, Imperial College London, 369 Fulham Road, London, UK

    Daqing Ma

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  1. Yang Xu
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Corresponding author

Correspondence to Yuantao Li.

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Funding

No funding was obtained by any of the authors for this study.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Xu, Y., Li, Y., Huang, X. et al. Single bolus low-dose of ketamine does not prevent postpartum depression: a randomized, double-blind, placebo-controlled, prospective clinical trial. Arch Gynecol Obstet 295, 1167–1174 (2017). https://doi.org/10.1007/s00404-017-4334-8

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  • DOI: https://doi.org/10.1007/s00404-017-4334-8

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