University of Texas at Arlington , Arlington , TX , United States of America .
Trends Psychiatry Psychother. 2020 Oct-Dec;42(4):318-328. doi: 10.1590/2237-6089-2019-0102.
The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors.
To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers.
Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias.
We found that the mediating effect of delivery mode depended on the adolescent's depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct.
Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.
青少年的分娩经历研究不足，尽管他们是一个特别容易经历负面分娩事件的脆弱群体，因为他们表现出许多已知的风险因素。
确定剖宫产分娩是否会影响婴儿并发症对青少年母亲分娩经历的影响。
我们使用先前对 303 名产后青少年进行抑郁和创伤后应激评估的数据进行二次分析，采用反事实因果分析来确定在不同抑郁水平下分娩方式是否会影响分娩经历。需要注意的局限性包括方法学假设和计算可行性以及潜在的样本偏差。
我们发现，分娩方式的中介效应取决于青少年的抑郁水平以及分娩经历的具体操作化。在轻度抑郁水平下，当以单一项目主观评分来操作时，负面分娩评估的可能性降低了约 30%。相比之下，在重度抑郁水平下，当以事件影响量表（IES）的子结构来操作时，负面分娩经历的可能性增加了 80%。
抑郁水平在调节分娩方式如何影响分娩经历方面起着关键作用。影响的方向也取决于分娩经历的操作化方式。
