Neck Disability and Depression in Postpartum Women with Epidural Anesthesia

Abstract

Background: Postpartum women who undergo cesarean delivery with epidural anesthesia may experience both musculoskeletal discomfort and psychological distress during the early recovery period, potentially affecting maternal functioning and well-being. Objective: To determine the prevalence of neck disability and depression in postpartum females who underwent cesarean section with epidural anesthesia and to assess the association between neck disability and depression. Materials and Methods: A cross-sectional study was conducted from March to September 2024 in selected hospitals of Sialkot using a non-probability convenience sampling technique (Ref # USKT/FAHS/RECLetter-00093). Females aged 20–40 years who had undergone cesarean delivery with epidural anesthesia within six weeks postpartum were included. Women with pre-existing musculoskeletal disorders, chronic neck pain, migraine, diagnosed anxiety or depression, neurological or spinal disorders, high-risk pregnancies, or use of anesthesia other than epidural were excluded. Neck disability was assessed using the Neck Disability Index (NDI), while postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using SPSS version 26.0, applying descriptive statistics and chi-square tests to determine associations. Results: Among 260 participants, the mean age was 28.43 ± 4.47 years. The mean NDI score was 24.46 ± 15.96, and the mean EPDS score was 15.18 ± 5.33. Nearly one-third of participants (28.8%) reported complete neck disability, while probable postpartum depression was observed in 70.4% of participants. A statistically significant association was found between neck disability and depression (p = 0.001), with higher depression rates observed as disability severity increased. Conclusion: A high prevalence of neck disability and postpartum depression was observed among females following cesarean delivery with epidural anesthesia, with a significant positive association between the two conditions