Lin Rong, Lu Yan, Luo Wei, Zhang Bing, Liu Zhiqiang, Xu Zhendong
Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Med (Lausanne). 2022 Sep 28;9:1001855. doi: 10.3389/fmed.2022.1001855. eCollection 2022.
Postpartum depression (PPD) has adverse effects on maternal and child health. Cesarean section (CS) is suggested to be associated with PPD, but no study has examined the risk factors for PPD in women who underwent CS. Therefore, this study aimed to investigate this association.
A prospective observational study was conducted between December 2020 and September 2021. In total, 590 women who underwent elective CS participated in this study. Data were collected using a questionnaire through a face-to-face interview at three time points: 32nd week of gestation, 2 days postpartum, and 6 weeks postpartum. PPD was defined by an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 11 at 6 weeks postpartum. Multivariate logistic regression analysis was performed to identify the risk factors for PPD.
Among the 590 women, 25.4% had PPD (142/590). After adjustment for the confounding factors, high antenatal self-rating anxiety scale score (OR = 1.10, 95% CI = 1.04-1.16), PPD symptoms (EPDS ≥ 11) at 2 days postpartum (OR = 6.17, 95% CI = 1.35-28.31), and pain at 6 weeks postpartum (OR = 2.14, 95% CI = 1.24-3.69) were independently associated with PPD.
Prenatal anxiety, PPD symptoms occurring at an early postoperative stage, and pain at 6 weeks postpartum may be associated with an increased risk of PPD among women who undergo CS.
产后抑郁症（PPD）对母婴健康有不良影响。剖宫产（CS）被认为与PPD有关，但尚无研究探讨接受CS的女性发生PPD的危险因素。因此，本研究旨在调查这种关联。
于2020年12月至2021年9月进行了一项前瞻性观察性研究。共有590名接受择期CS的女性参与了本研究。通过问卷调查，在三个时间点进行面对面访谈收集数据：妊娠32周、产后2天和产后6周。PPD的定义为产后6周爱丁堡产后抑郁量表（EPDS）得分≥11分。进行多因素逻辑回归分析以确定PPD的危险因素。
在590名女性中，25.4%患有PPD（142/590）。在对混杂因素进行调整后，产前焦虑自评量表得分高（OR = 1.10，95%CI = 1.04 - 1.16）、产后2天出现PPD症状（EPDS≥11）（OR = 6.17，95%CI = 1.35 - 28.31）以及产后6周疼痛（OR = 2.14，95%CI = 1.24 - 3.69）与PPD独立相关。
产前焦虑、术后早期出现的PPD症状以及产后6周疼痛可能与接受CS的女性发生PPD的风险增加有关。
