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Association between mode of delivery and postpartum depression

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eMediNexus    12 May 2018

A longitudinal study recently evaluated the association between mode of delivery and postpartum depression, considering the potentially mediating or confounding role of several covariates. The overall prevalence of postpartum depression was 13%. In comparison with spontaneous vaginal delivery, women who delivered by emergency cesarean section were found to be at higher risk for postpartum depression 6 weeks after delivery in crude but not in adjusted analysis. The path analysis revealed that emergency cesarean section and vacuum extraction had an indirect association with increased risk of postpartum depression, by leading to postpartum complications, self-reported physical symptoms postpartum, and hence a negative delivery experience. History of depression and fear of delivery increased the likelihood of postpartum depression and led more frequently to elective cesarean section; however, it was associated with a positive delivery experience. Mode of delivery did not have a direct link with the risk of postpartum depression. However, several modifiable or non-modifiable mediators are present in this association. Women delivering by emergency cesarean section or vacuum extraction, and having negative delivery experience form a high-risk group for postpartum depression. The findings are published in Acta Obstetricia et Gynecologica Scandinavica.

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