Mode of delivery and short-term maternal mental health: a follow-up
study in the Danish National Birth Cohort
Abstract
Objective: To examine associations between mode of delivery and maternal
mental health. Design: Prospective cohort study. Setting: Data from the
Danish National Birth Cohort. Population: A total of 54,474 women were
followed from diagnosis of pregnancy to 6 months postpartum. Methods:
From interviews in pregnancy and 6 months postpartum, the women reported
symptoms of anxiety, depression and stress. Mode of delivery was
categorised as spontaneous vaginal delivery, instrumental vaginal
delivery, planned caesarean section (CS) and emergency CS. Multiple
linear and logistic regression models were used to compute absolute
differences and odds ratios (ORs) with 95% confidence intervals (CIs)
for associations between delivery mode and mental health indicators.
Main outcome measures: Changes in combined score of emotional distress
from pregnancy to 6 months postpartum. Presence of emotional distress
and specific symptoms of anxiety, depression and stress 6 months
postpartum. Results: Mental health indicators improved from pregnancy to
6 months postpartum for all modes of delivery. Improvement was strongest
in mothers with planned CS and weakest in mothers with emergency CS. Six
months postpartum, symptoms of overall emotional distress were more
frequent in women with emergency CS (OR 1.21;1.06-1.37), as were
specific symptoms of anxiety (OR 1.11;0.98-1.24), depression (OR
1.25;1.09-1.43) and stress (OR 1.14;1.01-1.29). Symptoms of anxiety were
also more frequent in mothers with planned CS (OR 1.15;1.01-1.29).
Conclusions: Mental health indicators improved from pregnancy to 6
months postpartum regardless of delivery mode. Mothers with emergency CS
experienced more symptoms of emotional distress 6 months postpartum than
mothers with spontaneous vaginal birth.