Clinical Studyof Acupuncture Combined With Epidural Labor Analgesia On Postpartum Depression

Objective: Postpartum depression（PPD）is not only detrimental to maternal mental health,but also adversely affects the social cognitive function and behavioral development of newborns.With the development of society,people pay more and more attention to mental health problems.How to prevent and cure postpartum depression has become a hot research topic recently.This study intends to discuss acupuncture at Sanyinjiao point and Hegu point combined with epidural analgesia was used for labor analgesia to observe its effect on the incidence of PPD and serum glutamate（Glu）content,and to explore whether there is a correlation between the change of venous serum Glu content and the incidence of postpartum depression.Methods: A total of 180 full-term single primiparas were selected.The parturients who required labor analgesia were randomly divided into epidural labor analgesia group（group S）and acupuncture point combined with epidural labor analgesia group（group SA）.The parturients who did not require labor analgesia were set as the control group（group C）,with 60 cases in each group.Group S received 0.5μg/ml sufentanil combined with 0.08% ropivacaine for epidural labor analgesia.Group SA received acupuncture at Sanyinjiao point and Hegu point combined with0.5 μg/ml sufentanil combined with 0.08% ropivacaine for epidural labor analgesia.Group C did not implement labor analgesia and was treated according to the routine process of natural labor.Visual pain analogue score（VAS）were recorded when the uterine orifice was opened 2 cm（T0）,when the uterine orifice was fully opened（T1）and when the fetus was delivered（T2）in three groups.Serum glutamate level were measured by double-antibody sandwich ELISA immediately before analgesia,at the end of the third stage of labor,at 42 days postpartum,and the Edinburgh Postpartum Depression Scale（EPDS）score was performed at 42 days after delivery,and the incidence of postpartum depression was compared among the three groups.During T0～T2,the number of cases of pressing the analgesic pump and the occurrence of side effects were recorded.Newborn sex,newborn weight,newborn feeding patterns,the labor duration,the amount of postpartum blood loss at 2 hour and Bromage score after labor analgesia were recorded.Results: Compared with T0,the VAS score at T1 and T2 were lower in group SA and group S（P<0.01）.Compared with group C,VAS score were lower in group SA and group S when the uterine orifice was fully open and the fetus was delivered（P<0.01）,EPDS score and incidence of postpartum depression decreased at 42 days after delivery（P<0.05）,and the decrease was more obvious in group SA than in group S（P<0.05）.Compared with immediately before analgesia,the level of glutamate decreased in group SA and group S at the end of the third stage of labor and at 42 days after delivery（P<0.05）.Compared with group C,the level of glutamate in group SA and group S decreased at the end of the third stage of labor and at 42 days after delivery（P<0.05）,and the decrease was more obvious in group SA than in group S（P<0.05）.Conclusion: Acupuncture combined with epidural labor analgesia can reduce the incidence of PPD,and the mechanism may be related to the decrease of serum Glu level and alleviating labor pain.