Prenatal depression is an important risk factor of postpartum depression. Low-dose ketamine has been used for depression treatment. As a stereoisomer of ketamine, s-ketamine has similar effects to ketamine in anti-depression. We speculate that, for pregnant women with prenatal depression, low-dose s-ketamine infusion after childbirth may reduce the incidence of postpartum depression.
Studies have shown that prenatal depression symptoms are important predictors of postpartum depression. Screening of pregnant women's mental condition before giving birth, early identification of pregnant women with symptoms of prenatal depression, and providing appropriate interventions may play an important role in reducing the incidence of postpartum depression. Ketamine is an NMDA-receptor antagonist. In recent years, many studies confirmed that ketamine has a significant antidepressant effect. As a stereoisomer of ketamine, s-ketamine has similar effects to ketamine in anti-depression. In clinical application, s-ketamine has stronger analgesic effect, better anesthetic effect and lower incidence of adverse psychological reactions. We speculate that, for pregnant women with prenatal depression, low-dose s-ketamine infusions after childbirth may reduce postpartum depression. Evidence is lacking in this regard.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
364
S-ketamine (0.2 mg/kg in 20 ml normal saline) is administered by intravenous infusion in 40 minutes after childbirth.
Placebo (20 ml normal saline) is administered by intravenous infusion in 40 minutes after childbirth.
Peking University First Hospital
Beijing, Beijing Municipality, China
Beijing Tiantan Hospital
Beijing, Beijing Municipality, China
Peking University International Hospital
Beijing, Beijing Municipality, China
Hunan Provincial Maternal and Child Health Care Hospital
Changsha, Hunan, China
The incidence of depression at 42 days after childbirth.
PDepression at 42 days postpartum will be diagnosed by psychiatrists according to the Mini-International Neuropsychiatric Interview (MINI)-6.0.
Time frame: At 42 days after childbirth.
Maternal depression score at 7 days postpartum.
Maternal depression will be assessed with the Edinburgh Postnatal Depression Scale (EPDS; score range 0-30, with higher score indicating more severe depression). The assessment will be conducted by a telephone interview.
Time frame: At 7 days after childbirth.
Maternal depression score at 42 days postpartum.
Maternal depression will be assessed with the Edinburgh Postnatal Depression Scale (EPDS; score range 0-30, with higher score indicating more severe depression). The assessment will be conducted by a face-to-face interview or an online video interview.
Time frame: At 42 days after childbirth.
Maternal depression severity at 42 days postpartum.
Maternal depression severity will be assessed with the Hamilton Depression Scale-17
Time frame: At 42 days after childbirth.
Intensity of pain at 1, 7, and 42 days postpartum.
Intensity of pain will be assessed with the numeric rating scale (a 11-point scale where 0=no pain and 10=the worst pain).
Time frame: At 1, 7, and 42 days after childbirth.
Maternal breast feeding at 1, 7, and 42 days postpartum.
The mode of baby feeding include breast feeding, mixed feeding, or formula feeding.
Time frame: At 1, 7, and 42 days after childbirth.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Huaian Maternal and Child Health Care Hospital
Huaian, Jiangsu, China
Nanjing Maternal and Child Health Care Hospital
Nanjing, Jiangsu, China
Women's Hospital School Of Medicine Zhejiang University
Hanzhou, Zhejiang, China
Length of hospital stay after giving birth.
Length of hospital stay after giving birth.
Time frame: Up to 30 days after giving birth.
Incidence of maternal complications within 42 days postpartum.
Maternal complications are defined as those that are harmful to maternal health and require medical intervention.
Time frame: Up to 42 days after giving birth.
Incidence of neonatal diseases within 42 days.
Neonatal diseases are defined as those that require medical intervention.
Time frame: Up to 42 days after birth.