uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Obstetrik)
Show others and affiliations
2017 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: Although a number of perinatal factors have been implied in the etiology of postpartum depression (PPD), the role of mode of delivery remains controversial. Our aim was to explore the association between mode of delivery and PPD, considering the potentially mediating or confounding role of several covariates MATERIAL AND METHODS: In a longitudinal-cohort study in Uppsala, Sweden, with 3888 unique pregnancies followed-up postpartum, the effect of mode of delivery (spontaneous vaginal delivery, vacuum extraction, elective cesarean section, emergency cesarean section) on self-reported PPD symptoms (Edinburgh Postnatal Depression Scale ≥12) at six weeks postpartum was investigated through logistic regression models and path analysis RESULTS: The overall prevalence of PPD was 13%. Compared to spontaneous vaginal delivery, women delivered by emergency cesarean section were at higher risk for PPD six weeks after delivery in crude (OR: 1.45, 95%CI: 1.04-2.01), but not in adjusted analysis. However, the path analysis revealed that emergency cesarean section and vacuum extraction were indirectly associated with increased risk of PPD, by leading to postpartum complications, self-reported physical symptoms postpartum, and therefore a negative delivery experience. In contrast, history of depression and fear of delivery increased the odds of PPD, but also led more frequently to elective cesarean section, which was however associated with a positive delivery experience.

CONCLUSIONS: Mode of delivery has no direct impact on risk of PPD; nevertheless, several modifiable or non-modifiable mediators are present in this association. Women delivering at an emergency setting by emergency cesarean section or vacuum extraction, and reporting negatively experienced delivery comprise a high-risk group for PPD. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
2017.
Keyword [en]
cesarean section, delivery experience, mode of delivery, postpartum depression, vacuum extraction
National Category
Medical and Health Sciences
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-336797DOI: 10.1111/aogs.13275PubMedID: 29215162OAI: oai:DiVA.org:uu-336797DiVA: diva2:1167060
Available from: 2017-12-17 Created: 2017-12-17 Last updated: 2017-12-17

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Department of Women's and Children's Health
In the same journal
Acta Obstetricia et Gynecologica Scandinavica
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 8 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf