Effectiveness of transcutaneous auricular vagus nerve stimulation in alleviating postpartum blues following cesarean delivery: A randomized double-blind controlled trial.

Summary

In a double-blind RCT of 100 cesarean patients, 5 days of auricular taVNS reduced postpartum blues severity, improved mood scores, decreased EPDS ≥13 at 1 month (4% vs 26%), lowered acute postoperative pain at multiple time points, and improved sleep quality over postoperative days 1–4.

Key Findings

• Active taVNS produced a smaller increase in PPB VAS after mood induction on postpartum day 5 (median difference 4.13 cm; p<0.001).
• Mood improved on day 5 by Profile of Mood States and Stein Maternity Blues Scale (both p<0.001).
• EPDS ≥13 at 1 month postpartum was lower with taVNS (4%) vs sham (26%; p=0.003).
• Postoperative pain scores were reduced at 4, 12, 24, 48, and 72 hours (all p<0.001) and sleep quality improved on POD 1–4 (all p<0.001).

Clinical Implications

Consider taVNS as an adjunct in post-cesarean recovery pathways to mitigate early postpartum mood symptoms while also reducing pain and improving sleep; implementation should address device access, training, and patient selection.

Limitations

• Single-trial sample size (n=100) limits precision and generalizability.
• Primary outcomes are patient-reported; objective biomarkers and mechanistic endpoints were not assessed.

Future Directions

Multicenter trials to validate efficacy, define dose/parameter optimization, assess durability beyond 3 months, and evaluate implementation outcomes and cost-effectiveness.