Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study

Abstract

Objective To examine the relationship between delivery mode and postpartum depression at 6 weeks following hospital discharge.Design A prospective cohort study.Setting Eleven hospitals in Ontario, Canada.Sample A total of 2560 women ‡16 years of age who delivered singleton, live infants at term.Methods Women completed a questionnaire in hospital and 74% (n = 1897) participated in a structured telephone interview 6 weeks after discharge. Additional data were extracted from labour and delivery records. Generalised estimating equations (GEEs) were used to investigate factors associated with postpartum depression.Main outcome measure Women were screened for depression at 6 weeks following hospital discharge using the Edinburgh Postnatal Depression Scale (EPDS). A score of ‡12 on the EPDS was used as a measure of the primary outcome, depression.Results Mode of delivery was not independently associated with postpartum depression, and did not factor into the main-effects model. The multivariable analysis identified 11 predictor variables for depression: young maternal age (OR 5.27; 95% CI 2.73-10.15); maternal hospital readmission (OR 3.02; 95% CI 1.46-6.24); non-initiation of breastfeeding (OR 2.02; 95% CI 0.99-4.11); good, fair, or poor self-reported postpartum health (OR 1.82; 95% CI 1.19-2.80); urinary incontinence (OR 1.79; 95% CI 1.06-3.03); multiparity (OR 1.59; 95% CI 1.22-2.08); low mental health functioning (OR 1.20; 95% CI 1.15-1.25); low subjective social status (OR 1.16; 95% CI 1.02-1.33); high number of unmet learning needs in hospital (OR 1.12; 95% CI 1.03-1.22); low social support (OR 1.06; 95% CI 1.03-1.09); and low physical health functioning (OR 1.03; 95% CI 1.003-1.055). An exploratory interaction model revealed that caesarean section was associated with higher odds of becoming depressed in Canadian-born women, but that in women born outside of Canada it was associated with a lower risk of becoming depressed.Conclusions Delivery mode had no significant impact on the development of postpartum depression in the main-effects model. However, it may interact with place of birth and other unmeasured factors to create a risk for depression.

Depressive symptoms, pain, and sexual dysfunction over the first year following vaginal or cesarean delivery: A prospective longitudinal study

“…This inconsistency may reflect differences in study design, including the modes of delivery examined, the assessment instruments used, and the adjustments of covariates. In addition, we found no differences in the prevalence of depressive symptoms between the two groups at 4-6 weeks or at 6 and 12 months postpartum, consistent with the data of previous cross-sectional studies (Josefsson et al, 2002;Rauh et al, 2012;Sword et al, 2011) and follow-up studies conducted at 2 and 4 months postpartum (Sadat et al, 2014) and at 4 and 12 months postpartum (Durik et al, 2000). The cesarean group had a higher frequency of depressive symptoms at 3 months postpartum than did the vaginal group.…”

Doğum şeklinin doğum sonrası depresyon, algılanan sosyal destek ve maternal bağlanma ile ilişkisi

“…Benzer şekilde, Sword ve arkadaşlarının (19) 1897 kadın ile yaptığı geniş örneklemli bir araştırmada, SD'nin doğum sonrası altıncı haftada depresyon için bir risk etmeni olmadığı görülmüştür. Patel ve arkadaşları da (20) 10.934 kadın ile yaptıkları çalışmada, doğum şeklinin DSD üzerine bir etkisi olmadığını göstermişler-dir.…”

Has Delivery Method any Influence on the Postpartum Mood of the Mother? Postpartum SCL-90-R

“…In the study by Word et al (45) performed in the sixth postpartum week in Canada, they found that the method of delivery was not a risk factor for the development of postpartum depression. Another remarkable finding of this study was that postpartum stress was more common in mothers who were born in Canada and gave birth through cesarean delivery, but the rate of postpartum stress was higher in those born in other places and having vaginal birth.…”