Abstract
BackgroundDepression and anxiety are important mood changes in childbearing women. However, changes in depression and anxiety over time in women who undergo an elective cesarean section (CS) have not yet been elucidated. We aimed to characterize the trajectories of depressive and anxiety symptoms, and patterns of co-occurrence, and examined the associated predictors of depression and anxiety courses.MethodsA prospective longitudinal study of childbearing women (N = 139) who underwent a CS was conducted. Depressive and anxiety symptoms were respectively assessed using the Edinburgh Postnatal Depression Scale and State Anxiety Inventory, in the third trimester and at 1 day, 1 week, and 1 and 6 months postpartum.ResultsGroup-based modeling identified three distinct trajectories of depressive symptoms: group 1 (low, 30.9%), group 2 (mild, 41.7%), and group 3 (high, 27.3%). Four group trajectories of anxiety symptoms were identified: group 1 (low, 19.4%), group 2 (mild, 44.6%), group 3 (high, 28.8%), and group 4 (very high, 7.2%). Mild symptoms of both depression and anxiety were the most common joint trajectory. Depression trajectories were significantly related to anxiety trajectories (p<0.001). Predictors of the joint trajectory included the pre-pregnant body mass index (odds ratio (OR): 2.42, 95% confidence interval (CI): 1.1∼6.3) and a poor sleep score (OR: 3.2, 95% CI: 1.4∼7.3) in the third trimester.ConclusionsDistinctive trajectories and co-occurrence patterns of depressive and anxiety symptoms were identified. Our findings suggest a need for greater attention to continuous assessment of psychological well-being among women who undergo an elective CS.
Highlights
Cesarean sections (CSs) continue to rise globally, with an overall rate of 25.7% [1]
Several studies suggested that the increasing number of women receiving an elective CS without clinical indications may contribute to the rising trend of the CS rate [1]
Recent studies found that mothers with intense fear of childbirth were more likely to have elective caesarean sections [7,8] and often experienced elevated depression and anxiety symptoms [9]
Summary
Cesarean sections (CSs) continue to rise globally, with an overall rate of 25.7% [1]. Several studies suggested that the increasing number of women receiving an elective CS without clinical indications may contribute to the rising trend of the CS rate [1]. Factors such as the mother’s mood, anxiety, and fear of birth were associated with women’s preference for a CS [5]. Little is known concerning changes in depressed mood and anxiety over time among women who undergo an elective CS. Changes in depression and anxiety over time in women who undergo an elective cesarean section (CS) have not yet been elucidated. We aimed to characterize the trajectories of depressive and anxiety symptoms, and patterns of co-occurrence, and examined the associated predictors of depression and anxiety courses
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