Hung-Hui Chen1, Jerry Cheng-Yen Lai2, Shyh-Jou Hwang1,3, Nicole Huang4, Yiing-Jenq Chou1, Li-Yin Chien5. 1. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 2. Department of Medical Research, Taitung Mackay Memorial Hospital, Taitung, Taiwan. 3. Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan. 4. Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. 5. Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan.
Abstract
BACKGROUND: Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety, and depression. METHODS: This nationwide population-based cohort study was conducted using the Taiwan National Health Insurance Database. A total of 12 619 women who underwent cesarean birth and 12 619 control women who underwent vaginal birth were matched by propensity score based on age, socioeconomic status, residential urbanicity, antepartum comorbidity, and index year of delivery. We compared the incidence of stress, anxiety, and depression during the first postpartum year between cesarean and comparison groups by calculating incidence rate ratios (IRRs). RESULTS: The cesarean group showed a significantly higher risk for stress symptoms (IRR 1.4 [95% confidence interval {CI} 1.02-1.92]), but not anxiety (IRR 1.14 [95% CI 0.95-1.38]) or depression (IRR 1.32 [95% CI 0.94-1.87]), although the IRRs were also greater than one. The cesarean group had a significantly higher risk of any of the above-listed three disorders than the comparison group (incidence 27.6 vs 23.4 per 1000 person-years; IRR 1.18 [95% CI 1.01-1.38]). CONCLUSIONS: Cesarean birth was associated with an increased risk of postpartum stress symptoms. Health professionals should avoid unnecessary cesarean birth, pay attention to women who deliver by cesarean, and intervene appropriately in an attempt to improve mental health among postpartum women.
BACKGROUND:Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety, and depression. METHODS: This nationwide population-based cohort study was conducted using the Taiwan National Health Insurance Database. A total of 12 619 women who underwent cesarean birth and 12 619 control women who underwent vaginal birth were matched by propensity score based on age, socioeconomic status, residential urbanicity, antepartum comorbidity, and index year of delivery. We compared the incidence of stress, anxiety, and depression during the first postpartum year between cesarean and comparison groups by calculating incidence rate ratios (IRRs). RESULTS: The cesarean group showed a significantly higher risk for stress symptoms (IRR 1.4 [95% confidence interval {CI} 1.02-1.92]), but not anxiety (IRR 1.14 [95% CI 0.95-1.38]) or depression (IRR 1.32 [95% CI 0.94-1.87]), although the IRRs were also greater than one. The cesarean group had a significantly higher risk of any of the above-listed three disorders than the comparison group (incidence 27.6 vs 23.4 per 1000 person-years; IRR 1.18 [95% CI 1.01-1.38]). CONCLUSIONS: Cesarean birth was associated with an increased risk of postpartum stress symptoms. Health professionals should avoid unnecessary cesarean birth, pay attention to women who deliver by cesarean, and intervene appropriately in an attempt to improve mental health among postpartum women.
Authors: Sharon Dekel; Tsachi Ein-Dor; Zohar Berman; Ida S Barsoumian; Sonika Agarwal; Roger K Pitman Journal: Arch Womens Ment Health Date: 2019-04-30 Impact factor: 3.633
Authors: Alice Mannocci; Sara Ciavardini; Federica Mattioli; Azzurra Massimi; Valeria D'Egidio; Lorenza Lia; Franca Scaglietta; Andrea Giannini; Roberta Antico; Barbara Dorelli; Alessandro Svelato; Luigi Orfeo; Pierluigi Benedetti Panici; Antonio Ragusa; Giuseppe La Torre; Happy Mama Group Journal: Int J Environ Res Public Health Date: 2022-01-27 Impact factor: 3.390