臨床婦人科産科77巻1号

2023年01月発行

合併増大号　今月の臨床 最善で最新の産科麻酔診療をめざして 分娩時の麻酔―硬膜外無痛分娩

硬膜外鎮痛と産後うつ・母乳哺育

著者： 秋永智永子¹

所属機関： ¹浜松医科大学医学部附属病院麻酔科蘇生科

ページ範囲：P.133 - P.137

●硬膜外無痛分娩の産後うつに対する影響はいまだ明らかではない．

●硬膜外無痛分娩の母乳哺育に対する影響はいまだ明らかではない．

●母乳哺育困難が予想される患者に対しては，より注意深いサポートが必要である．

参考文献

1）Aoyagi S-S, et al : Association of late-onset postpartum depression of mothers with expressive language development during infancy and early childhood : the HBC study. PeerJ 7 : e6566, 2019

2）Takeda S, et al : Annual report of the perinatology committee, Japan Society of Obstetrics and Gynecology, 2015 : proposal of urgent measures to reduce maternal deaths. J Obstet Gynaecol Res 43 : 5-7, 2017

3）日本産科婦人科学会，他（編・監修） : CQ 420産褥精神障害の取り扱いは？．産婦人科診療ガイドライン―産科編2020．pp271-274，日本産科婦人科学会，2020

4）Gastaldon C, et al : Risk factors of postpartum depression and depressive symptoms : umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. Br J Psychiatry, 2022（in press）

5）Ding T, et al : Epidural labor analgesia is associated with a decreased risk of postpartum depression : a prospective cohort study. Anesth Analg 119 : 383-392, 2014

6）星　貴江，他 : 硬膜外麻酔による無痛分娩を選択した女性への心理的ケアモデルの開発と試作．科学研究費助成事業研究成果報告書．2017年6月21日

7）佐々木和子 : 母親の出産方法の選択と出産体験 その後の健康状態・育児に関する縦断的研究．ブイツーソリューション，2018

8）Wang J, et al : Association between neuraxial labor analgesia and postpartum depression : a meta-analysis. J Affect Disord 311 : 95-102, 2022

9）Orbach-Zinger S, et al : A systematic review of the association between postpartum depression and neuraxial labor analgesia. Int J Obstet Anesth 45 : 142-149, 2021

10）Almeida M, et al : The association between labor epidural analgesia and postpartum depression : a systematic review and meta-analysis. BMC Womens Health 20 : 99, 2020

11）Kountanis JA, et al : Labor epidural analgesia and the risk of postpartum depression : a meta-analysis of observational studies. J Clin Anesth 61 : 109658, 2020

12）Orbach-Zinger S, et al : The relationship between women's intention to request a labor epidural analgesia, actually delivering with labor epidural analgesia, and postpartum depression at 6 weeks : a prospective observational study. Anesth Analg 126 : 1590-1597, 2018

13）Lim G, et al : Obstetric pain correlates with postpartum depression symptoms : a pilot prospective observational study. BMC Pregnancy Childbirth 20 : 240, 2020

14）Heesen P, et al : Labor neuraxial analgesia and breastfeeding : an updated systematic review. J Clin Anesth 68 : 110105, 2021

15）French CA, et al : Labor epidural analgesia and breastfeeding : a systematic review. J Hum Lact 32 : 507-520, 2016

16）Beilin Y, et al : Effect of labor epidural analgesia with and without fentanyl on infant breast-feeding. Anesthesiology 103 : 1211-1217, 2005

17）Wilson MJA, et al : Epidural analgesia and breastfeeding : a randomized controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group. Anaesthesia 65 : 145-153, 2010

18）Lee AI, et al : Epidural labor analgesia-fentanyl dose and breastfeeding success : a randomized clinical trial. Anesthesiology 127 : 614-624, 2017

19）American College of Obstetricians and Gynecologists : ACOG Practice bulletin No.209 : Obstetrics Analgesia and Anesthesia. Obstet Gynecol 133 : e208-e225, 2019

20）Martin E, et al : ABM clinical protocol#28, Peripartum analgesia and anesthesia for the breastfeeding mother. Breastfeed Med 13 : 164-171, 2018