Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS)combined with epidural analgesia on postpartum depression and to explore its underlying mechanism. Methods One hundred and twenty cases of full-term primiparous women with singleton pregnancy were selected from May 2018 to November 2018 in Jinzhong Maternal and Child Health Hospital. The parturients with labor analgesia requirement were randomly divided into the epidural group and the combination group

and the parturients without labor analgesia requirement were used as the control group

with 40 cases in each group. Patients in the control group did not receive labor analgesia and were treated according to the routine procedures of natural delivery; patients in the epidural group received epidural labor analgesia; patients in the combination group received TEAS at bilateral Hegu(LI4)

Sanyinjiao(SP6) and Zusanli(ST36)(2 Hz/100 Hz

the current intensity is gradually increased from 15 mA

and the treatment was performed every 2 h

20 min each time) combined with epidural labor analgesia. The visual analogue scale(VAS) scores were recorded when the uterine orifice opened to 3

6

8

10 cm. Plasma glutamate was measured using high-performance liquid chromatography before analgesia

at the end of the third stage of labor and 42 days after delivery

and Edinburgh postnatal depression scale(EPDS) score was measured at 42 days after delivery.Results In comparison with the control group

the VAS score

EPDS score and the incidence of postpartum depression of the epidural group and the combination group were significantly lower(P<0.05)

and the combination group had significant decrease than those in epidural group(P<0.05). Immediately before analgesia

there was no statistically significant difference in glutamate levels among the 3 groups(P>0.05). Compared with the control group

at the end of the third stage of labor and 42 days postpartum

the glutamate levels of the epidural group and the combination group were significantly reduced(P<0.05)

and the combination group decreased more significantly than the epidural group(P<0.05). Conclusion TEAS combined with epidural analgesia can reduce the incidence of postpartum depression

possibly by down-regulating plasma glutamate level and relieving of labor pain.