[Study of the relation of gynecologic and obstetric findings and psychological disorders of pregnancy and the puerperium].

The relationship between gynaecological and obstetrical parameters and psychological troubles in pregnancy and after delivery are a matter of much debate. This arises partly because of different methods of studying the conditions and because of epidemiological studies that have been carried out on this subject. This longitudinal prospective study has been carried out on 211 women who were delivered in the maternity department of Louis Mourier Hospital. The figure for anxiety (in the de Bonis scale of greater than or equal to 20) was 13 to 15% at different times in the pregnancy, of depression (in the CESd scale greater than or equal to 16) was between 11 and 14.5%. 34.5% of those women who had delivered suffered from "baby blues", while 20% had symptoms of depression (CESd greater than or equal to 16 in the first week post-partum) and 6% had a quite obvious syndrome of depression (MADRS greater than or equal to 20). Finally, 18 to 24.5% of women had a major episode of depression (according to the DSM III test) in the year following delivery. As far as risk factors were concerned there was a statistically significant correlation between anxiety and depression in pregnancy and induction of labour, as well as difficulties with the third stage of labour and with an Apgar score of less than 9 in the infant. There was poor correlation between "baby blues" and gynaecological and pathological changes except where vaginal delivery was not spontaneous and where large episiotomies were carried out. On the other hand, women who had pathological labours or cesareans or a general anaesthetic for the third stage had more troubles than others in the year following delivery. Finally, women who showed signs of anxiety or depression in pregnancy or had "baby blues" after delivery were less likely to be able to breast feed their children.