Department of Obstetrics and Gynecology, University Perinatal Center for Franconia, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
Arch Gynecol Obstet. 2012 Dec;286(6):1407-12. doi: 10.1007/s00404-012-2470-8. Epub 2012 Jul 31.
To compare depressiveness scores, both during and after pregnancy, with the delivery mode (DM).
In a longitudinal, prospective study, standardized questionnaires for the Edinburgh Postnatal Depression Scale were presented to 1,100 women and used to assess the presence and severity of depressiveness at three time points: prenatal, from the 30th gestational week (Q1); 48-72 h postnatal (Q2); and 6-8 months postnatal (Q3). The patients were divided into four groups relative to DM: spontaneous delivery, primary cesarean section (CS), secondary CS, and assisted vaginal delivery. The final number of participating women with both delivery mode and depression information for all three time points was 753.
There was a significant difference of the mean EPDS values between the spontaneous delivery and primary CS groups (P=0.04) at Q1 (5.1 vs. 6.3). None of the other comparisons was significant. Significant differences relative to DM were seen at Q2 (P<0.0001), but there were no significant differences between the patient groups at Q3 (P=0.54).
DM only showed coherence with the extent of depression briefly during the peripartal period. A relationship was found between depressiveness during pregnancy and DM, with higher depressiveness scores in the group of patients undergoing primary CS. This should be taken into account when patients requesting an elective cesarean section are being counseled.
比较孕期和产后抑郁评分与分娩方式（DM）的关系。
在一项纵向前瞻性研究中，对 1100 名女性使用标准化的爱丁堡产后抑郁量表问卷，分别在三个时间点（产前、妊娠第 30 周（Q1）；产后 48-72 小时（Q2）；产后 6-8 个月（Q3））评估抑郁的发生和严重程度。根据 DM 将患者分为四组：自然分娩、初次剖宫产（CS）、再次 CS 和辅助阴道分娩。最终有 753 名女性同时具有分娩方式和所有三个时间点的抑郁信息。
在 Q1（5.1 对 6.3）时，自然分娩组和初次 CS 组的 EPDS 值的平均值有显著差异（P=0.04）。其他比较均无统计学意义。在 Q2（P<0.0001）时，与 DM 相关的差异有统计学意义，但在 Q3 时各患者组之间无统计学差异（P=0.54）。
DM 仅在围产期短暂时间内与抑郁程度相关。妊娠期间的抑郁与 DM 之间存在相关性，初次 CS 组的抑郁评分较高。在为要求选择性剖宫产的患者提供咨询时，应考虑这一点。
