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Effect of depressive and anxiety symptoms during pregnancy on risk of obstetric interventions
Author(s) -
Bayrampour Hamideh,
Salmon Charleen,
Vinturache Angela,
Tough Suzanne
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12683
Subject(s) - medicine , anxiety , pregnancy , odds ratio , psychological intervention , obstetrics , depression (economics) , medical record , psychiatry , genetics , macroeconomics , economics , biology
Aim The effect of prenatal mental health on the risk of obstetric interventions is unclear. The present study examined the associations between depressive and anxiety symptoms in the second and third trimesters and mode of delivery, epidural use and labor induction in a large community‐based pregnancy cohort, in A lberta, C anada. Material and Methods Women who had singleton pregnancies, delivered in hospital, and had medical data were selected ( n = 2825). Obstetric intervention data were obtained from the medical records, and depressive and anxiety symptoms were measured by the E dinburgh P ostnatal D epression S cale and the S pielberger S tate A nxiety I nventory. Data were evaluated with multivariate multinomial and logistic regression analyses using a hierarchical modeling. Results After accounting for factors known to increase the risk of each intervention, including demographic variables, smoking, hospital site, gestational age, previous history of cesarean delivery, prepregnancy body mass index, assisted conception, and antepartum risk score, the only mental health variable associated with obstetric interventions was depressive symptoms in the third trimester, which increased the risk of emergency cesarean delivery (adjusted odds ratio, 2.04; 95% confidence interval, 1.26–3.29). No associations were found between antenatal depressive and anxiety symptoms and other obstetric interventions. Conclusion The present findings support an association between depressive symptoms and adverse obstetric outcomes and suggest that anxiety and depression may have different effects on obstetric outcomes. Understanding the mechanism in which depression increases the risk of emergency cesarean birth needs further research.