Mode of delivery and postpartum emotional distress: a cohort study of 55 814 women

Authors

  • SS Adams,

    1. Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
    2. Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, Oslo, Norway
    Search for more papers by this author
  • M Eberhard-Gran,

    1. Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
    2. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
    Search for more papers by this author
  • ÅR Sandvik,

    1. Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
    Search for more papers by this author
  • A Eskild

    1. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
    2. Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
    Search for more papers by this author

Dr SS Adams, Health Services Research Centre, Akershus University Hospital, 1478 Lørenskog, Norway. Email samantha.s.adams@ahus.no

Abstract

Please cite this paper as: Adams S, Eberhard-Gran M, Sandvik Å, Eskild A. Mode of delivery and postpartum emotional distress: a cohort study of 55 814 women. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03188.x

Objective  To assess the association between mode of delivery and maternal postpartum emotional distress.

Design  A prospective study of women from 30 weeks of gestation to 6 months postpartum.

Setting  Pregnant women in Norway during the period 1998–2008.

Population  A total of 55 814 women from the Norwegian Mother and Child Cohort Study.

Methods  Emotional distress was reported in a short form of the Hopkins Symptom Checklist-25 (SCL-8) at 30 weeks of gestation and at 6 months postpartum. Information on mode of delivery was obtained from the Medical Birth Registry of Norway.

Main outcome measures  Changes in SCL-8 score from 30 weeks of gestation to 6 months postpartum and presence of emotional distress at 6 months postpartum.

Results  Women with instrumental vaginal, emergency caesarean or elective caesarean deliveries had similar changes in SCL-8 score between 30 weeks of gestation and 6 months postpartum, as compared with women with unassisted vaginal delivery (adjusted regression coefficient, 0.00, 95% CI –0.01 to 0.01; 0.01, 95% CI 0.00−0.02; and −0.01, 95% CI −0.02 to 0.00, respectively). The corresponding odds ratios (ORs) associated with the presence of emotional distress at 6 months postpartum (SCL-8 ≥ 2.0) were: OR 1.01, 95% CI 0.86−1.18; OR 1.13, 95% CI 0.97−1.32; and OR 0.96, 95% CI 0.79−1.16, respectively. These estimates were adjusted for emotional distress during pregnancy and other potential confounding factors. Emotional distress during pregnancy showed the strongest association with the presence of emotional distress at 6 months postpartum (adjusted OR 14.09, 95% CI 12.77−15.55).

Conclusions  Mode of delivery was not associated with a change in SCL-8 score from 30 weeks of gestation to 6 months postpartum or with the presence of emotional distress postpartum.

Ancillary