Maternal Dissatisfaction During the Postpartum Recuperation Period is an Independent Risk Factor for Postpartum Depression after Caesarean Section in China – A Prospective Cohort Study

Abstract Background: Postpartum depression (PD) is a common disorder associated with severe adverse infant and maternal outcomes, which is becoming an important public health problem. However, studies on the clinical relevance of anesthesia and PD are very limited. This study aimed to examine risk factors for PD amongst Chinese parturients of caesarean section from the perspective of anesthesiology, especially during the standard Chinese postpartum recuperation period known as “doing the month”.Methods: Prospective cohort study of 125 women who received caesarean sections aged from 21 to 46 years. The Edinburgh Postnatal Depression Scale were evaluated at the day before caesarean section and 6 weeks postpartum. Demographic, clinical, and treatment, including postoperative prognostic data and conditions during “doing the month”, were recorded and compared between PD and non-PD groups. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with the occurrence of PD. Results: 44 (34.9%) patients were diagnosed PD at 6 weeks postpartum. Occurrence of PD was associated with postoperative pain, pruritus, dissatisfaction with “doing the month”. Multivariate regression analysis showed that lumbago (OR 5.68, 95% CI 1.69-19.06; p=0.005), maternal total dissatisfaction during “doing the month”(OR 6.87, 95% CI 2.48-19.04; p=0.001), and dissatisfaction with mother in-law during “doing the month”(OR 3.22, 95% CI 1.43-16.16; p=0.020) were independent risk factors for PD, while mild activity pain was independent protective factor for PD 6 weeks postpartum (OR 0.018, 95% CI 0.01-0.25; p=0.003). Conclusions: PD was a commonly experienced psychological disorders for women undergoing caesarean section. Postpartum lumbago, maternal total dissatisfaction and dissatisfaction with mother in-law during “doing the month” and mild activity pain were main factors for PD at 6 weeks postpartum.