Evidence map›Paper›PMID 40328197›Full record

ArticleJournal of clinical anesthesia2025

Cerebrospinal fluid proteome of patients with persistent pain and/or postpartum depression after elective cesarean delivery: An exploratory prospective cohort study.

Mary Yurashevich, Michael Devinney, Matthew W Foster, Rachel Myers, Nicholas O'Grady, Ru-Rong Ji, Ashraf S Habib, Miles Berger

Abstract read
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In one paragraph

Article in Journal of clinical anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mary YurashevichDepartment of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA. Electronic address: mary.yurashevich@duke.edu.
Michael DevinneyDepartment of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA.
Matthew W FosterDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Duke University, Durham, NC, USA; Duke Proteomics and Metabolomics Core Facility, Duke University, Durham, NC, USA.
Rachel MyersBioinformatics and Clinical Analytics Team, Department of Medicine Clinical Research Unit, Duke University Medical Center, Duke University, Durham, NC, USA.
Nicholas O'GradyBioinformatics and Clinical Analytics Team, Department of Medicine Clinical Research Unit, Duke University Medical Center, Duke University, Durham, NC, USA.
Ru-Rong JiDepartment of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA; Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA.
Ashraf S HabibDepartment of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA.
Miles BergerDepartment of Anesthesiology, Duke University Medical Center, Duke University, Durham, NC, USA.

Funding

INTEGRATED TRAINING IN ANESTHESIOLOGY RESEARCHT32GM008600 · NIGMS · DUKE UNIVERSITY · PI Miriam Treggiari · 1996 to 2026
$6.6M
APOE4 dependent regulation of CSF Complement Pathway Activation in the development of Alzheimer's DiseaseR01AG076903 · NIA · STANFORD UNIVERSITY · PI Miles Berger · 2022 to 2026
$4.1M
Neuro-inflammation in Postoperative Cognitive Dysfunction: CSF and fMRI StudiesK76AG057022 · NIA · DUKE UNIVERSITY · PI BERGER, MILES · 2017 to 2022
$1.4M
NIA NIH HHS K76 AG057022NIA NIH HHS R01 AG076903NIGMS NIH HHS T32 GM008600
6 · The paper itself

Abstract

backgroundPersistent pain (>2 months) after cesarean delivery (CD) can affect up to 20 % of patients, and is associated with increased risk for postpartum depression (PPD). Preoperative identification of patients at risk for persistent pain and PPD remains a challenge due to poorly understood underlying mechanisms. To better understand these potential mechanisms, here, we examined the preoperative cerebrospinal (CSF) proteome for changes associated with persistent pain or PPD at 3 months post-CD.

methodsEighty patients undergoing elective CD under neuraxial anesthesia were recruited. We collected baseline demographics, obstetric data, and Edinburgh Postnatal Depression Scale (EPDS) scores. EPDS and pain scores were also obtained at 3 months post-CD. CSF was collected before spinal anesthetic placement. Liquid chromatography coupled with tandem mass spectrometry was used to study the CSF proteome.

results63 patients completed clinical follow-up, however only 61 of the patients had adequate preoperative CSF sample for analysis. Of these 61 patients, 21 developed pain or PPD at 3 months post-CD (14 had persistent pain alone and 7 had PPD alone). Over 1600 proteins were quantified in each CSF sample. Forty-three of these proteins were nominally differentially expressed in patients with persistent pain and/or PPD vs those with neither disorder. Pathway analysis showed a downregulation of the complement and coagulation cascades in the preoperative CSF of patients who later developed persistent pain or PPD 3 months after CD.

conclusionsThese results suggest that the CSF complement and coagulation cascades may play a role in patients who develop postpartum pain or PPD 3 months later.

Indexed as

Cesarean SectionChronic PainDepression, PostpartumPostoperative PainProteomeAdultAnesthesia, SpinalBiomarkersElective Surgical ProceduresFemaleFollow-Up StudiesHumansPain MeasurementPregnancyProspective StudiesBiomarkersProteomeCerebrospinal fluidCesarean deliveryPersistent painPostpartum depressionProteomics

Identifiers

PMID40328197
PMCPMC13265051

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.