Comparison of Postpartum Depression Incidence in Patients Undergoing Cesarean Section with and Without Ketamine Use: A Retrospective Cohort Study

Abstract Ketamine is increasingly being explored as a treatment for depression and has been studied for its potential prophylactic effects in postpartum depression (PPD). This study aims to analyze data from a large population to determine ketamine's efficacy in preventing PPD in patients without a prior history of depression and mitigating symptom escalation in those with a history of depression. Using data from TriNetX, a global health research network, we compare the incidence of PPD among patients who received ketamine during cesarean section delivery versus those who did not. Background: Ketamine has gained attention as a potential treatment for depression, including postpartum depression (PPD). However, its role in preventing PPD remains uncertain, with conflicting findings in existing literature. Objective: This study aimed to evaluate the association between ketamine use during cesarean section and the subsequent risk of PPD. Methods: Data were extracted from TriNetX, a global health research network, to assess the incidence of PPD in patients who received ketamine during cesarean section versus those who did not. Risk analysis was conducted to determine the relative risk, odds ratio, and absolute risk difference. Results: The incidence of PPD was significantly higher in the ketamine group (8.0%) compared to the non-ketamine group (2.6%), with a risk difference of 5.3% (p = 0.000). The risk ratio (3.017) and odds ratio (3.191) indicated that women who received ketamine were approximately three times more likely to develop PPD than those who did not. Conclusion: These findings challenge the notion that ketamine provides a protective effect against PPD. Instead, they suggest that ketamine use during cesarean section may increase the risk of developing PPD, particularly in the absence of prior depression. Further research is needed to explore the underlying mechanisms and potential modifiers of this association.