This study aimed to explore the effect of prophylactic
ketamine administration on
postpartum depression in Chinese woman undergoing
cesarean section. This randomized controlled study included 654 Chinese women undergoing
cesarean section. At 10 min after child birth, patients in the
ketamine group were given 0.5 mg/kg
ketamine, whereas patients in the control group received standard
postpartum care. At the end of operation, all patients were armed with a patient-controlled intravenous
analgesia device. The primary outcome was the prevalence of
postpartum depression (
PPD), as assessed by the Edinburgh Postnatal Depression Scale (EPDS), and the secondary outcomes included the safety assessment and the Numerical Rating Scale (NRS) of
postoperative pain. The prevalence of postpartum blues and
postpartum depression were significantly lower in the
ketamine group than in the control group. Logistic analysis showed that
ketamine administration protected against
postpartum depression, and
PPD-associated risk factors included stress during pregnancy, antenatal depressive symptom and antenatal suicidal ideation. In addition, the antidepressive effect of prophylactic
ketamine was stronger in mothers with a history of moderate stress during pregnancy, antenatal depressive symptom and antenatal suicidal ideation. Our findings suggest that
ketamine functions as a prophylactic agent against
PPD.