BACKGROUND Postpartum depression impacts maternal health, child development, and overall family well being. General anaesthesia has been suggested as a potential risk factor. OBJECTIVE To assess the association between anaesthetic methods and postpartum depression in women undergoing Caesarean section. DESIGN Systematic review with meta-analysis. DATA SOURCES We searched PubMed, Embase and Web of Science through 16 April 2025, and included seven studies comprising 1 482 355 patients. ELIGIBILITY CRITERIA Randomised controlled trials and cohort studies comparing postpartum depression outcomes in women undergoing Caesarean section with general anaesthesia versus non-general anaesthesia. RESULTS Our results showed that general anaesthesia significantly increased the risk of both overall postpartum depression odds ratio (OR) = 1.64, 95% confidence interval (CI), 1.23 to 2.19 and severe postpartum depression (OR = 1.41, 95% CI, 1.35 to 1.47). Subgroup analysis stratified by timing of postpartum depression diagnosis revealed an elevated risk within one-year postpartum (OR = 1.22, 95% CI, 1.02 to 1.46) and an even higher risk within seven-day postpartum (OR = 4.68, 95% CI, 1.21 to 18.09). CONCLUSION These findings highlight the importance of anaesthetic choices for Caesarean section and suggest that minimising general anaesthesia exposure may optimise both physical and mental health outcomes.
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