Mode of delivery and short-term maternal mental health: Afollow-up study in the Danish National Birth Cohort.

Abstract

To estimate associations between mode of delivery and maternal mental health 6months postpartum. Follow-up of mothers in the Danish National Birth Cohort. Symptoms of anxiety, depression or stress were self-reported at gestational week 30 and 6months postpartum. Mode of delivery was categorized as spontaneous vaginal birth, instrumental vaginal birth, planned cesarean section and emergency cesarean section. Multiple linear and logistic regression models were used to compute differences and odds ratios (ORs) with 95% confidence intervals (CIs) for associations between delivery mode and mental health indicators adjusted for mental health before and during pregnancy. Among 54 474 mothers, mental health indicators improved from pregnancy to 6months postpartum for all delivery modes. Improvement was smallest in mothers with emergency cesarean section. Thus, compared to women with a spontaneous vaginal birth, women with emergency cesarean section more frequently reported 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) 6months postpartum, and women with planned cesarean section more frequently reported symptoms of anxiety (OR 1.15; 1.01-1.29). Mental health improved from pregnancy to 6months postpartum regardless of delivery mode. Mothers with emergency cesarean section experienced more symptoms of emotional distress 6months postpartum.