Cesarean Section and Postpartum Anxiety and Depression of Primiparas in a Cohort of Chinese Women with a High Cesarean Delivery Rate
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DIAO Chunting, PENG Jinjing, HU Zhen
The purpose of the study was to examine whether Cesarean Section is associated with elevated postpartum symptoms of depression and anxiety. Whether it will influence mother's decision of have another baby. Postpartum depression and anxiety are very common among women, especially for primiparas. However, previous studies have yielded inconsistent results. Our research is a prospective, group-comparative cohort study, contains 327 healthy primiparas, and the participants were stratified three groups according to the mode of delivery: elective cesarean section (n=99), emergency cesarean section (n=108), vaginal birth (including intervention) (n=120). The postpartum anxiety and depression were collected using the Hospital Anxiety and Depression Scale within 6 months after delivery. The three groups of first-time mothers showed significant difference on postpartum anxiety(χ2=24.082, P<0.001) and depression (χ2=35.591, P<0.001), the women undergoing emergency cesarean section had more suspicious and affirmative depression symptoms than vaginal delivery group and elective cesarean section group (P <0.001); the women undergoing cesarean section had more suspicious and affirmative anxiety symptoms than vaginal delivery group(p<0.001); but there was no significant difference between the women undergoing elective cesarean section and emergency cesarean section(χ2=3.892, P=0.143). When after childbirth, the number of wanting another baby have a significantly decline for emergency cesarean section group (P <0.001). The primipara who underwent cesarean section, particularly emergency cesarean section, had a higher level of postpartum anxiety and depression compared to natural birth. emergency cesarean section can lead to a high-level postpartum anxiety and depression,then affects the willing of have another baby. We should try to encourage conform to the natural conditions of maternal natural childbirth, strictly control the hospital cesarean section production ratio, reasonable comfort indications of cesarean section maternal mood.
Delivery modes; Anxiety; Depression; Primipara