Abstract：
Postpartum depression (PPD) is a psychiatric condition affecting women post-childbirth. Medication combined with psychotherapy, is the current protocol for its treatment. A meta-analysis was conducted using RevMan 5.4 to explore the efficacy and safety of peri-partum administration of esketamine for preventing PPD. After searching several databases to retrieve the relevant RCTs, seven were included in this analysis, with dichotomous data presented as risk ratio and continuous data as mean difference. The study found a lower incidence of PPD in the esketamine group compared to the control group (RR= 0.37), with significant difference in EPDS scores between the two groups (MD= -1.23) in the first week postpartum. The esketamine group reported a lower prevalence of PPD 4-6 weeks postpartum (RR= 0.48), and no significant difference in EPDS scores after 4 weeks postpartum (MD = -0.10). The esketamine group had a significantly higher incidence of hallucination (RR= 13.85). Other adverse effects, such as dizziness (RR= 4.09), nausea (RR= 0.88), vomiting (RR=0.74), headache (RR=1.52), nightmares (RR=1.22), pruritus (RR=0.29), and drowsiness (RR=1.57) did not show significant differences between the two groups. The study found that esketamine, with manageable side effects, reduces the prevalence of post-partum depression (PPD) after one week as well as after four to six weeks. However, the findings are limited by the limited number of available RCTs, and future research should determine the ideal dosage, the most effective method of administration and the long-term safety profile of esketamine so that it may be considered as an adjunct therapy or a potential sole treatment option.
摘要：
产后抑郁症（PPD）是一种影响分娩后妇女的精神疾病。药物结合心理治疗，是目前的治疗方案。使用RevMan5.4进行荟萃分析，以探讨围产期给予艾氯胺酮预防PPD的有效性和安全性。在搜索了几个数据库以检索相关的RCT之后，七个被包括在这个分析中，将二分数据表示为风险比，将连续数据表示为平均差。研究发现，与对照组相比，艾氯胺酮组的PPD发生率较低（RR=0.37），在产后第一周，两组之间的EPDS评分存在显着差异（MD=-1.23）。esketamine组报告产后4-6周PPD的患病率较低（RR=0.48），产后4周后EPDS评分无显著差异(MD=-0.10)。艾氯胺酮组的幻觉发生率明显较高（RR=13.85）。其他不良影响,如头晕（RR=4.09），恶心（RR=0.88），呕吐（RR=0.74），头痛（RR=1.52），噩梦（RR=1.22），瘙痒（RR=0.29），和困倦（RR=1.57）在两组之间没有显着差异。研究发现艾氯胺酮,有可控的副作用，一周后以及四至六周后降低产后抑郁症（PPD）的患病率。然而,研究结果受到可用RCT数量有限的限制，未来的研究应该确定理想的剂量，最有效的给药方法和艾氯胺酮的长期安全性，因此可以将其视为辅助治疗或潜在的唯一治疗选择。
