Depression and Anxiety Trajectories among Women Who Undergo an Elective Cesarean Section

Abstract

BackgroundDepression and anxiety are important mood changes in childbearing women. However, changes in depression and anxiety over time in women who undergo an elective cesarean section (CS) have not yet been elucidated. We aimed to characterize the trajectories of depressive and anxiety symptoms, and patterns of co-occurrence, and examined the associated predictors of depression and anxiety courses.MethodsA prospective longitudinal study of childbearing women (N = 139) who underwent a CS was conducted. Depressive and anxiety symptoms were respectively assessed using the Edinburgh Postnatal Depression Scale and State Anxiety Inventory, in the third trimester and at 1 day, 1 week, and 1 and 6 months postpartum.ResultsGroup-based modeling identified three distinct trajectories of depressive symptoms: group 1 (low, 30.9%), group 2 (mild, 41.7%), and group 3 (high, 27.3%). Four group trajectories of anxiety symptoms were identified: group 1 (low, 19.4%), group 2 (mild, 44.6%), group 3 (high, 28.8%), and group 4 (very high, 7.2%). Mild symptoms of both depression and anxiety were the most common joint trajectory. Depression trajectories were significantly related to anxiety trajectories (p<0.001). Predictors of the joint trajectory included the pre-pregnant body mass index (odds ratio (OR): 2.42, 95% confidence interval (CI): 1.1∼6.3) and a poor sleep score (OR: 3.2, 95% CI: 1.4∼7.3) in the third trimester.ConclusionsDistinctive trajectories and co-occurrence patterns of depressive and anxiety symptoms were identified. Our findings suggest a need for greater attention to continuous assessment of psychological well-being among women who undergo an elective CS.

A systematic review of growth curve mixture modelling literature investigating trajectories of perinatal depressive symptoms and associated risk factors

“…It has also increasingly been used to explore trajectories of depressive symptoms among women during the perinatal period (Kuo et al, 2014; Mora et al, 2009; Sutter-Dallay et al, 2012). To our knowledge, the findings of these studies have not yet been systematically synthesised.…”

Existe associação entre os desconfortos no puerpério imediato e a via de parto? Um estudo observacional

“…Diferentemente da crença popular na vivência de menor morbidade puerperal, a literatura tem demonstrado maiores riscos de susceptibilidade à redução da saú-de física 15,16 e emocional das mulheres após cesárea 17 .…”

The Influence of Progressive Muscle Relaxation on Anxiety Level of Pre-Caesarean Section Mothers in Delivery Room

“…China mencatat angka kelahiran melalui SC meningkat dari 6% pada tahun 1998 menjadi 46% pada tahun 2009. Demikian juga di Taiwan, angka kelahiran SC menunjukkan angka semakin pesat yakni 33,9% pada tahun 2006 dan 37,6% pada tahun 2012 (Kuo, Chen & Tzeng, 2014). Studi pendahuluan yang telah dilakukan di RSUD dr. Haryoto Kabupaten Lumajang mendapatkan data bahwa jumlah persalinan SC di Ruang Bersalin sepanjang tahun 2016 adalah 62% dari total 1021 persalinan.…”

“…Dampak dari terjadinya kecemasan pra operasi dikaitkan dengan peningkatan rasa sakit pasca operasi, kebutuhan analgesik, peningkatan masa rawat inap di rumah sakit dan dikaitkan juga dengan kejadian depresi post partum (Kuo, Chen, & Tzeng, 2014;Sahin et al, 2016). Intervensi keperawatan yang dapat dilakukan untuk mengatasi klien dengan kecemasan salah satunya melalui pemberian terapi progressive muscle relaxation (PMR).…”

“…Pendidikan dan pengetahuan juga merupakan faktor yang dapat mempengaruhi kecemasan pada klien yang akan menjalani operasi mayor elektif (Kuraesin, 2009). Peningkatan kecemasan yang terjadi pada ibu pre operasi SC berkorelasi dengan penambahan durasi proses pemulihan pasca operasi SC sehingga akan menambah masa rawat inap di RS, peningkatan rasa sakit pasca operasi, kebutuhan analgesik, dan berkorelasi dengan terjadinya depresi post partum (Pawatte, Pali & Opod, 2013;Kuo, Chen, & Tzeng, 2014;Sahin et al, 2016). Sebaliknya, penurunan kecemasan preoperatif menunjukkan keterkaitan yang signifikan dengan peningkatan kepuasan dan peningkatan masa pemulihan ibu post operasi SC sehingga perlu diberikan intervensi baik secara farmakologis maupun non farmakologis untuk menurunkan kecemasan sebelum operasi guna meningkatkan hasil klinis setelah operasi (Hobson, 2006).…”