Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first‐time mothers

Wangel, Anne-Marie; Molin, Johan; Östman, Margareta; Jernström, Helena

doi:10.1111/j.1600-0412.2010.01056.x

Cited by 28 publications

(23 citation statements)

References 31 publications

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“…not offered an elective CS), as the increased risk for emergency CS indicates. A previous study associated the markers stress, worry and sleeping problems with an emergency CS in first-time mothers who presented with a singleton cephalic baby for vaginal delivery [17]. These self-reported expressions of mental ill-health that we have taken as markers might support the theory that a woman's own awareness of potential complications during childbirth is potentially mediated by anxiety (worry, stress) in pregnancy [30].…”

Section: Discussionmentioning

confidence: 63%

“…Perinatal staff enters routine information for preset standard variables and additional free-text, whenever clinically requested. Data mining of standard variables and a free-text search of truncated word units makes it possible to identify markers of mental ill-health that may be precursors to measurable mental health problems [17].…”

Section: Methodsmentioning

confidence: 99%

“…Another study found an increased risk of emergency CS associated with markers of mental ill-health such as stress (adjusted OR 1.66; 95% CI 1. 34-2.06) in records of pregnant women [17].…”

Section: Original Articlementioning

confidence: 99%

“…The method of identifying markers denoting mental illhealth in records of women with complete EMR data by use of a free-text search (as truncated word units), has been previously described; it is a type of systematic text mining [17,23]. The meaning of the self-reported Swedish words signifying mental ill-health translate into English adjectives, nouns and verbs as the markers: anti-depressant; dejected ('feeling blue'); depressed; panic/anxiety (combined because of overlapping records); sleep (disturbance or problems); stress; suicide; threat; worry.…”

Section: Perinatal Datamentioning

confidence: 99%

See 3 more Smart Citations

Prior psychiatric inpatient care and risk of cesarean sections: a registry study

Wangel

Molin

Moghaddassi

et al. 2011

Journal of Psychosomatic Obstetrics & Gynecology

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This study of 17,443 childbearing women, investigated the relationship between hospital admissions 5 years prior to index birth, type of mental disorders and risk factors for mode of delivery. Hospital based electronic perinatal medical records between 2001 and 2006, were linked with the Swedish National Inpatient Care Registry 1996-2006. Of all the women, 39.3% had had inpatient care prior to index birth (27.3% had had obstetric, 10.1% somatic, and 1.9% psychiatric inpatient care). Diagnoses of mental disorders at psychiatric admission (n=333) were categorized into five groups: personality/behavioral/unspecified disorder (30.9%), affective disorders and 'suicide attempt' (28.9%), neurotic/somatoform disorders (18.9%), substance use (17.1%) and schizophrenia (4.2%). Women with history of psychiatric care were more often smokers, below age 24 and single (p<0.001, respectively), had more markers of mental ill-health in pregnancy records (p≤0.001), compared to women without such previous care, and fewer were nulliparous (p<0.001). The results show that women with prior psychiatric inpatient care and those with identified mental ill-health in pregnancy records, were associated with increased adjusted risks of cesarean sections. Identifying a woman?s mental health status in pregnancy may predict and prevent emergency cesarean section.

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Section: Discussionmentioning

confidence: 63%

Section: Methodsmentioning

confidence: 99%

“…Another study found an increased risk of emergency CS associated with markers of mental ill-health such as stress (adjusted OR 1.66; 95% CI 1. 34-2.06) in records of pregnant women [17].…”

Section: Original Articlementioning

confidence: 99%

Section: Perinatal Datamentioning

confidence: 99%

See 2 more Smart Citations

Prior psychiatric inpatient care and risk of cesarean sections: a registry study

Wangel

Molin

Moghaddassi

et al. 2011

Journal of Psychosomatic Obstetrics & Gynecology

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“…In Taiwanese, Swedish, and American samples, fatigue and sleep deprivation have been associated with increased risk of caesarean sections [15,17,33]. American women reporting less total sleep time experienced higher levels of labour pain and more fatigue during labour [34].…”

Section: Introductionmentioning

confidence: 99%

A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women

Hall

Stoll

Hutton

et al. 2012

BMC Pregnancy Childbirth

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BackgroundObstetrical interventions, including caesarean sections, are increasing in Canada. Canadian women’s psychological states, fatigue, and sleep have not been examined prospectively for contributions to obstetric interventions and adverse neonatal outcomes.Context and purpose of the study: The prospective study was conducted in British Columbia (BC), Canada with 650 low-risk pregnant women. Of those women, 624 were included in this study. Women were recruited through providers’ offices, media, posters, and pregnancy fairs. We examined associations between pregnant women’s fatigue, sleep deprivation, and psychological states (anxiety and childbirth fear) and women’s exposure to obstetrical interventions and adverse neonatal outcomes (preterm, admission to NICU, low APGARS, and low birth weight).MethodsData from our cross-sectional survey were linked, using women’s personal health numbers, to birth outcomes from the Perinatal Services BC database. After stratifying for parity, we used Pearson’s Chi-square to examine associations between psychological states, fatigue, sleep deprivation and maternal characteristics. We used hierarchical logistic regression modeling to test 9 hypotheses comparing women with high and low childbirth fear and anxiety on likelihood of having epidural anaesthetic, a caesarean section (stratified for parity), assisted vaginal delivery, and adverse neonatal outcomes and women with and without sleep deprivation and high levels of fatigue on likelihood of giving birth by caesarean section, while controlling for maternal, obstetrical (e.g., infant macrosomia), and psychological variables.ResultsSignificantly higher proportions of multiparas, reporting difficult and upsetting labours and births, expectations of childbirth interventions, and health stressors, reported high levels of childbirth fear. Women who reported antenatal relationship, housing, financial, and health stressors and multiparas reporting low family incomes were significantly more likely to report high anxiety levels. The hypothesis that high childbirth fear significantly increased the risk of using epidural anaesthesia was supported.ConclusionsControlling for some psychological states and sleep quality while examining other contributors to outcomes decreases the likelihood of linking childbirth fear anxiety, sleep deprivation, and fatigue to increased odds of caesarean section. Ameliorating women’s childbirth fear to reduce their exposure to epidural anaesthesia can occur through developing effective interventions. These include helping multiparous women process previous experiences of difficult and upsetting labour and birth.

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Sleep disturbances and depressive and anxiety symptoms during pregnancy: associations with delivery and newborn health

Peltonen

Paavonen

Saarenpää‐Heikkilä

et al. 2022

Arch Gynecol Obstet

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Background Sleep disturbances and mood symptoms are common in late pregnancy; according to the literature, they can affect delivery and newborn outcomes. This study evaluated the effect of sleep and mood symptoms on delivery and newborn health, because there are insufficient and partly contradictory studies on the topic. Methods A cohort of 1414 mothers in their third trimester was enrolled in this prospective cross-sectional questionnaire study. Validated questionnaires were assessed for the measurement of sleep disturbances and depressive and anxiety symptoms. The data on delivery and newborn outcomes were obtained from hospital medical records. Results Sleep disturbances were very common. A higher insomnia score (β = − 0.06, p = 0.047) and longer sleep need (β = 0.07, p = 0.047) were related to delivery at a lower gestational age. In addition, a higher insomnia score (β = − 28.30, p = 0.010) and lower general sleep quality (β = − 62.15, p = 0.025) were associated with lower birth weight, but longer sleep duration and longer sleep need with a higher birth weight (β = 28.06, p = 0.019; β = 27.61, p = 0.028, respectively). However, the findings regarding birth weight lost their significance when the birth weight was standardized by gestational weeks. Concerning Apgar scores and umbilical artery pH, no associations were found. Snoring was associated with a shorter duration of the first phase of delivery (β = − 78.71, p = 0.015) and total duration of delivery (β = − 79.85, p = 0.016). Mothers with higher insomnia, depressive, or anxiety symptoms were more often treated with oxytocin (OR 1.54 95% CI 1.00–2.38, p = 0.049, OR 1.76, 95% CI 1.02–3.04, p = 0.049 and OR 1.91, CI 95% 1.28–2.84, p < 0.001, respectively) and those with higher depressive and anxiety symptoms were delivered more often with elective cesarean section (OR 4.67, 95% CI 2.04–12.68, p < 0.001 and OR 2.22, 95% CI 1.03–4.79, p = 0.042). Conclusions Maternal sleep disturbances and mood symptoms during pregnancy are associated with delivery and newborn health. However, nearly, all the outcomes fell within a normal range, implying that the actual risks are low.

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Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first‐time mothers

Cited by 28 publications

References 31 publications

Prior psychiatric inpatient care and risk of cesarean sections: a registry study

Prior psychiatric inpatient care and risk of cesarean sections: a registry study

A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women

Sleep disturbances and depressive and anxiety symptoms during pregnancy: associations with delivery and newborn health

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