The effects of anesthetic agents used in cesarian section on melatonin levels and the association with postpartum depression

Objective: Gestational and postnatal phases are the most exceptional periods of women. This is a phase which the mother is affected both phisically and mentally as she bears a new child. Melatonin is one of the most influential hormones on circadian rythm, and plenty of studies have been conducted about melatonin and depression association. In our study we aim to establish the effects of anesthetic agents used in cesarean section on melatonin levels, and to evaluate the possible association of melatonin levels and postpartum depression. Materials and Methods: Our study has been approved by the Erzincan Binali Yıldırım University Ethics Comitee. We included 231 pregnant women between the ages of 18-45 which have been admitted for cesarean section to Erzincan Mengücek Gazi Training and Research Hospital Anesthesiology and Reanimation Clinic. The pregnant women have been divided into 3 groups which underwent general, spinal and combined spinal-epidural anesthesia respectively. These approaches were determined by the preference of the attending anesthesiologist. Postoperative first day at 5:00 am, peripheral venous blood samples were obtained from the subjects for melatonin level measurement. Samples were centrifuged and kept in -80°C until the testing for melatonin with ELISA method. In order to determine the depression status, the subjects were evaluated with Edinburgh Postpartum Depression Scale. Results: All the anesthesia types that was given to the subjects; 16% was combine spinal epidural anestesia, 18,2% was general anesthesia and 65,8% was spinal anesthesia. According to the scale 68% of the subjects had no depression and 32% had depression. There was a statistically significant difference (p<0,001) between the timing of the operation and anesthesia method. The depression rate in subjects that underwent general anesthesia was significantly higher than other groups (p<0,001). There was no significant difference between the timing of operation and depression status (p=0,901). The association between anesthesia method and melatonin levels had no statistically significant difference (p=0,53). The association between operation timing and melatonin levels had no statistically significant difference (p=0,139). The VII association between depression status and melatonin levels had no statistically significant difference among the two groups (p=0,097). Conclusion: We aimed to evaluate the effect of the chosen anesthesia method on postoperative melatonin levels and postpartum depression, and we found that the chosen method of anesthesia does not affect postoperative melatonin levels significantly but the usage of general anesthesia significantly rises the postpartum depression rate among subjects. And also we did not find any correlation between postoperative melatonin levels and postpartum depression.