- Mahrokh Dolatian
 - - Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
- Pouneh Maziar
- - Ministry of Health & Medical Sciences, Tehran, Iran
- Hamid Alavimajd
- - Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Mohsen Yazdjerdi
- - Department of Community Medicine and Biostatistics, Faculty of Medicine, Guilan University of Medical Sciences, Tehran, Iran
Received: 10/1/2006 Accepted: 10/1/2006 - Publisher : Avicenna Research Institute |
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Abstract
Introduction: Postpartum period is the most vulnerable time for the onset of mood disorders including the blues, depression and psychosis. Depression is the most important mood disorder in the postpartum period that can be associated with mother-baby and family conflictual interactions and may lead to irreparable consequences if not addresses well. Regarding different etiologies of postpartum depression, among them mode of delivery, and the existence of numerous controver-sies about this matter, the present study was conducted to determine the relationship between mode of delivery and postpartum depression in pregnant women attending some selected Health Centers affiliated to Shahid Beheshti University of Medical Sciences in 2005.Materials & Methods: In this prospective analytical study, 258 pregnant women in their 3rd trimester of pregnancy were evaluated for signs of depression within 8 months and about 50 peo-ple were excluded from the study because of depression (Getting more than 12 from Edinburgh Postnatal Depression Scale, EPDS) and those not suffering from depression were included in the study. Subjects who had histories of quitting parents before the age of 15, abortion, infertility, complications during pregnancy, prolonged pregnancy, postpartum complications, chronic diseases, nervous diseases in the family, hospitalization of the mother or the neonate and those with fetal demise were excluded from the study too. During 2 to 6 weeks from delivery, study subjects completed EPDS, marital satisfaction and social support questionnaires, were divided into NVD (73 women) and CS (75 women) groups and were matched for confounding factors before statistical analysis. Data analysis was performed by SPSS software, version 13, and the significance level was considered 0.05.Results: The mean age of subjects was 22.71+3.15 years. Most of them had high school diplomas and were housewives. The prevalence of postpartum depression was 20.3%. 13.6%of the cases in NVD and 27.6% in CS groups scored more than 12 on EPDS and they were at risk for postpartum depression. There was a significant relationships between mode of delivery and postpartum depre-ssion (p<0.05 ) and a two fold risk for depression was seen in cs group (or="2)." conclusion: according to the findings of this study that postpartum depression has been twice as much prevalent in the cs group compared to that of nvd group, it can be concluded that cs should be performed in women who meet the criteria for this procedure. implementing this strategy can have an effective role in preventing postpartum depression and help reduce expenses from its proper practice.< pan>
Keywords:
Postpartum depression, Delivery, Normal vaginal delivery, Caesarian section, Marital satisfaction, Social support, PMS To cite this article:References
- Gale S, Harlow BL. Postpartum mood disorders: a review of clinical and epidemiological factors. J Psy-chosom Obstet Gynecol. 2003;24(4):257-66. Review [PubMed]
- Nonacs R, Cohen LS. Postpartum mood disorders: diagnosis and treatment guidelines. J Clin Psychiatry. 1998;59 (suppl2): 34-40. Review [PubMed]
- Petrou S, Cooper P, Murray L, Davidson LL. Economic costs of post-natal depression in a high-risk British cohort. Br J Psychiatry. 2002;181:505-12 [PubMed]
- Adewuya AO, Fatoye FO, Ola BA, Ijaodola OR, Ibigbami SM. Sociodemographic and obstetric risk factors for postpartum depressive symptoms in Nigerian women. J Psychiatr Pract. 2005;11(5):353-8 [PubMed]
- Patel RR, Murphy DJ, Peters TJ. Operative delivery and postnatal depression: a cohort study BMJ. 2005; 16;330(7496):879. Epub 2005 [PubMed]
- Latorre-Latorre JF, Contreras-Pezzotti LM, Herran-Falla OF. Postnatal depression in a Colombian city. Risk factors. Aten Primaria. 2006;15,37(6):332-8 [PubMed]
- Wickberg B, Hwang CP. The Edinburgh postnatal depression scale: validation on a Swedish community sample. Acta Psychiatr Scand. 1996;94(3):181-4 [PubMed]
- Sadock B, Sadock V. Kaplan & Sadock Compre-hensive text book of psychiatry. 7th Edition. Lippincott Williams & Wilkins. 2000;pp:1276-83
- صالحي كسائي پروين. بررسي مقايسه اي شيوع افسردگي بعد از زايمان در دو گروه از مادران با زايمان طبيعي و سزارين. پايان نامه كارشناسي ارشد، دانشگاه علوم پزشكي تهران .1373. دانشكده پرستاري و مامايي
- بهبودي مقدم زهرا. بررسي ميزان شيوع افسردگي بعد از زايمان و عوامل مؤثر بر آن در خانم‌هاي مراجعه کننده به مراکز بهداشتي درماني وابسته به دانشگاه علوم پزشکي شهيد بهشتي. پايان نامه کارشناسي ارشد مامائي. 1380دانشکده پرستاري ومامائي
- Lowdermilk L, Perry E, Bobak M. Maternity & Women Health Care. 7th Edition. USA Mosby. 2000; pp:940-964
- Josefsson A, Angelsioo L, Berg G, Ekstron CM, Gunnervik C. Obstetric, somatic and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol. 2002;99(2):223-8 [PubMed]
- Ryan J, Berkowitz S, Barbieri L, Dunaif A. Kistner,s gynecology & women,s health. 7th Edition. New york Mosby, Inc. 1999;pp:519-539
- Mallikarjun PK, Oyebode F. Prevention of postnatal depression. J R Soc Health. 2005; 125(5):221-6. Review [PubMed]
- دفترسلامت خانواده و جمعيت معاونت سلامت (1379) سيماي جمعيت و سلامت در جمهوري اسلامي ايران تهران. وزارت بهداشت، درمان و آموزش پزشكي
- ترکان بهناز. بررسي مقايسه‌اي کيفيت زندگي مادران در دو روش زايمان طبيعي و سزارين. پايان نامه کارشناسي ارشد، دانشگاه تربيت مدرس، دانشکده پرستاري ومامائي، 1383
- Fisher J, Astbury J, Smith A. Adverse psychological impact of operative obstetric interventions: a prospective longitudinal study. Aust N Z J Psychiatry. 1997;31(5):728-38 [PubMed]
- Clement S. Psychological aspect of cesarean section. Best Practic Research Clinical Obstet & Gynaecol. 2001;15 (1):109-126 [PubMed]
- Carter FA, Frampton CM, Mulder RT. Cesarean sec-tion and postpartum depression: a review of the evidence examining the link. Psychosom Med. 2006;68 (2):321-30. Review [PubMed]
- Cox JL, Holden JM, Sagovsky R. Detection of post-natal depression. Development of the 10-item Edin-burgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-6 [PubMed]
- Harris B, Huckle P, Thomas R, Johns S, Fung H. The use of rating scales to identify post-natal depression. Br J Psychiatry. 1989;154:813-7 [PubMed]
- Murray L, Carothers AD. The validation of Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry. 1990;157:288-90 [PubMed]
- Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO. Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand. 2001;104(4):243-9 [PubMed]
- Uwakwe R, Okonkwo JE. Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand. 2003;107(4):251-9 [PubMed]
- Boyce PM, Todd AL. Increased risk of postnatal depression after emergency caesarean section. Med J Aust. 1992;157(3):172-4 [PubMed]
- Ukpong DI, Owolabi AT. Postpartum emotional distress: a controlled study of Nigerian women after caesarean childbirth. J Obstet Gynaecol. 2006;26(2): 127-9 [PubMed]
- Wong D, Perry E, Hockenberry J, Lowdermilk L. Wilson D. Maternal Child Nursing Care. 3rd Edition. USA Mosby. 2006; pp: 674-679
- Ryding EL, Wijma K, Wijma B. Experience of emer-gency cesarean section: a phenomenological study of 53 women. Birth. 1998;25(4):246-51 [PubMed]