Assessment of peripartum psychological disturbances in relation to modes of delivery

Abstract

Assessment of peripartum psychological disturbances in relation to modes of delivery Ali S Radeef1, Muna Kh Al-Kubaisi2*, Akbar B John3, Nur Khairulnisa AI2 1. Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia 2. Department of Obstetrics and Gynaecology, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia 3. Kulliyyah of Science, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia *E-mail: mkubaysi@gmail.com Abstract Background: Anxiety disorders are common during peripartum period. This study aimed to identify which mode of delivery was more prone to develop psychological disturbances. Methods: This prospective cohort study conducted among 541 pregnant women presented for spontaneous labour, induction or elective caesarean section in a Malaysian hospital. The severity of depression, anxiety and stress symptoms are assessed by using self-rated depression anxiety and stress scales in four different occasions; pre-labour/operation, 24 hours postnatal, 2 weeks, and at 6 weeks. Results: In the prenatal period, there was no statistically significant difference in the mean score of depression between women coming for labour (4.17±5.28) and elective CS (4.21±5.87). During puerperium; at 24 hours postnatal, 2 weeks and 6 weeks assessments there was no significant difference in depression score among patients with different modes of delivery. The overall scores were (4.23±5.46, 3.26±4.85, 0.78±2.37, 0.18±0.93) for patients going through vaginal delivery, instrumentation, emergency or elective CS. The same trend was found when anxiety and stress were analysed. Conclusions: The most prominent peripartum psychological disturbances symptom is anxiety. Minority of patients will experience persistence anxiety by the end of 6 weeks postpartum. The caesarean section and induction of labour does not increase the psychological impact. Keywords: anxiety, caesarean section, depression, induction of labour, stress