Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 5;33(5):209-216.
doi: 10.2188/jea.JE20210117. Epub 2022 Apr 15.

Association Between Mode of Delivery and Postpartum Depression: The Japan Environment and Children's Study (JECS)

Sachiko Baba  1 , Satoyo Ikehara  2 , Ehab S Eshak  2   3 , Kimiko Ueda  4 , Tadashi Kimura  5 , Hiroyasu Iso  2
Affiliations

Association Between Mode of Delivery and Postpartum Depression: The Japan Environment and Children's Study (JECS)

Sachiko Baba et al. J Epidemiol. .

Abstract

Background: Postpartum depression (PPD) has been associated with adverse health outcomes, including maternal suicide. Mode of delivery has been suggested to be a risk factor for PPD, but no large cohort study has examined the association between mode of delivery and PPD. We aimed to examine the association between mode of delivery and risks of PPD at 1 and 6 months after childbirth.

Methods: In a nationwide study of 89,954 mothers with a live singleton birth, we examined the association between mode of delivery and risks of PPD. PPD was evaluated using the Edinburgh Postnatal Depression Scale (≥13) at 1 and 6 months after childbirth. Odds ratios (ORs) with 95% confidence intervals (CIs) of PPD were calculated using multivariable logistic regression analyses after adjustment of antenatal physical, socioeconomic, and mental factors.

Results: Among 89,954 women, 3.7% and 2.8% had PPD at 1 and 6 months after childbirth, respectively. Compared with unassisted vaginal delivery, cesarean section (CS) was marginally associated with PPD at 1 month but not at 6 months; adjusted ORs were 1.10 (95% CI, 1.00-1.21) and 1.01 (95% CI, 0.90-1.13), respectively. The association with PPD at 1 month was evident in women with antenatal psychological distress (adjusted OR 1.15; 95% CI, 1.03-1.28). The observed associations were attenuated after adjusting for infant feeding method.

Conclusion: Women who had antenatal psychological distress and underwent CS delivery may be regarded as a target for monitoring PPD.

Keywords: breastfeeding; cesarean section; postpartum depression; prospective study; psychological distress.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None declared.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379–407. 10.1146/annurev-clinpsy-050212-185612 - DOI - PubMed
    1. Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018;104:235–248. 10.1016/j.jpsychires.2018.08.001 - DOI - PubMed
    1. Patel M, Bailey RK, Jabeen S, Ali S, Barker NC, Osiezagha K. Postpartum depression: a review. J Health Care Poor Underserved. 2012;23(2):534–542. 10.1353/hpu.2012.0037 - DOI - PubMed
    1. Iwata H, Mori E, Sakajo A, Aoki K, Maehara K, Tamakoshi K. Prevalence of postpartum depressive symptoms during the first 6 months postpartum: association with maternal age and parity. J Affect Disord. 2016;203:227–232. 10.1016/j.jad.2016.06.002 - DOI - PubMed
    1. Kingston D, Tough S, Whitfield H. Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry Hum Dev. 2012;43:683–714. 10.1007/s10578-012-0291-4 - DOI - PubMed

Publication types