The effect of probiotic supplementation on episiotomy wound healing and postpartum depression in primiparous mothers A randomized controlled trial

Abstract

Abstract IntroductionThe prevalence of episiotomy in Iran is much higher than the rates reported in other parts of the world. The episiotomy incision site is located in a place where there is a high possibility of the wound being infected with bacteria from the vagina and vulva. Therefore, delay in wound healing increases the possibility of infection. Probiotics have the ability to create anti-inflammatory reactions and accelerate the wound healing process. So far, no study has been conducted to measure the effect of probiotics on the healing process of episiotomy wounds. On the other hand, considering the report of two-way relationship between gut and brain function in many mental disorders and contradictory findings of clinical trials of probiotics treatment on depression and considering the common effect of Lactobacillus casei on wound healing and depression, the present study aims It was designed to determine the effect of Lactobacillus casei on episiotomy wound healing and postpartum depression in primiparous mothers.Materials and methodsThis randomized controlled clinical trial was conducted on 74 primiparous women who gave birth at Al-Zahra Medical Center in Tabriz, who had a mediolateral episiotomy and met the conditions to be included in the study. Wound healing rate was evaluated by Rida scale and episiotomy pain rate was evaluated by visual pain scale before discharge, 5±1 and 15±1 days after delivery. Also, the Edinburgh depression scale was completed 5±1, 15±1 and 21±1 days after delivery. Repeated measures ANOVA was used to compare episiotomy repair, pain and postpartum depression between two groups.Findings In this study, there were no significant differences between the two groups in terms of demographic and obstetric characteristics (P>0.05). The episiotomy wound healed over time in both groups. The healing process was faster in the probiotic group than in the placebo group. The mean (standard deviation) of wound healing 15±1 days after delivery was in the intervention group 0.95 (0.27) and in the placebo group 1.45 (0.71) (AMD = 0.50; confidence interval 95%= -0.5 to -0.96; p=0.03). also 21±1 days after delivery There was no significant difference between the two groups in terms of depression score, (AMD=-1.68; 95% CI=--0.80 to 2.56; p=0.71). There was no statistically significant difference in the pain score between the two groups (p=0.66).ConclusionThe results showed that casei probiotic oral supplement heals the episiotomy wound, but it has no effect on postpartum pain and depression