Crippling Performance Issues: RelStorage/PostgreSQL DB with 44M+ ZODB Objects

Do you have versioning enabled? How many objects do you have from the plone catalog? ZODB object caches?

Did you search in the forum? I've found this that maybe can give some hint:

but seems to be related to the speed of the query. Anyway, adding an index can speed up that query while you're looking for the real problem.