Association between postpartum depression and anaesthesia methods in women undergoing caesarean section

BACKGROUND Postpartum depression impacts maternal health, child development, and overall family well being. General anaesthesia has been suggested as a potential risk factor. OBJECTIVE To assess the association between anaesthetic methods and postpartum depression in women undergoing Caesarean section. DESIGN Systematic review with meta-analysis. DATA SOURCES We searched PubMed, Embase and Web of Science through 16 April 2025, and included seven studies comprising 1 482 355 patients. ELIGIBILITY CRITERIA Randomised controlled trials and cohort studies comparing postpartum depression outcomes in women undergoing Caesarean section with general anaesthesia versus non-general anaesthesia. RESULTS Our results showed that general anaesthesia significantly increased the risk of both overall postpartum depression [odds ratio (OR) = 1.64, 95% confidence interval (CI), 1.23 to 2.19] and severe postpartum depression (OR = 1.41, 95% CI, 1.35 to 1.47). Subgroup analysis stratified by timing of postpartum depression diagnosis revealed an elevated risk within one-year postpartum (OR = 1.22, 95% CI, 1.02 to 1.46) and an even higher risk within seven-day postpartum (OR = 4.68, 95% CI, 1.21 to 18.09). CONCLUSION These findings highlight the importance of anaesthetic choices for Caesarean section and suggest that minimising general anaesthesia exposure may optimise both physical and mental health outcomes.