Depressed mood, anxiety, and the use of labor analgesia

Arch Womens Ment Health. 2016 Feb;19(1):11-6. doi: 10.1007/s00737-015-0572-6. Epub 2015 Sep 21.


Relatively little is known about mental health and labor pain. The aim of this study was to assess if self-rated antenatal depressed mood and anxiety are associated with pain-related behaviors and self-reported labor pain. We also wanted to replicate our previous finding of altered labor pain behavior in carriers of a specific guanosine triphosphate cyclohydrolase 1 gene (GCH1) haplotype. Ninety-nine women in gestational weeks 37 to 40 filled out questionnaires on depression and anxiety symptoms and later rated their labor pain by use of visual analog scales. Each subject was also genotyped for GCH1. Following adjustment for relevant confounders, women who arrived early to the delivery unit (cervical dilation <5 cm) had a significantly higher antenatal Montgomery-Åsberg Depression Rating Scale (MADRS-S) score, p < 0.05, than late arrivers (cervical dilation >5 cm). Women with increased Spielberger State-Trait Anxiety Inventory (STAI-T) scores reported higher self-rated pain prior to labor analgesia, p < 0.05, than women with low STAI-T scores. No association between the GCH1 pain-protective haplotype and cervical dilation was found, but a previously demonstrated association with increased use of second-line analgesia was confirmed. Depressed mood during pregnancy is associated with early arrival to the delivery department, whereas antenatal anxiety is associated with increased self-rated pain prior to labor analgesia.

Keywords: Anxiety; Depressed mood; GCH1; Labor pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia, Obstetrical*
  • Anxiety / diagnosis
  • Anxiety / drug therapy*
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / drug therapy*
  • Depression / psychology
  • Female
  • GTP Cyclohydrolase / genetics*
  • Genotype
  • Genotyping Techniques
  • Humans
  • Labor Pain / drug therapy*
  • Labor Pain / genetics
  • Labor Pain / psychology*
  • Multivariate Analysis
  • Pain Measurement
  • Polymorphism, Single Nucleotide
  • Pregnancy
  • Pregnancy Trimester, Third / blood
  • Prospective Studies
  • Surveys and Questionnaires
  • Sweden
  • Visual Analog Scale


  • GTP Cyclohydrolase