The Association of Antenatal Depression and Cesarean Delivery Among First Time Parturients: A population based study

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Objective: Antenatal depression (AD) has been considered a risk factor for cesarean delivery (CD); however, the supporting data inconsistent. We used a large, nationally representative dataset to evaluate whether there is an association between AD and CD among women delivering for the first time. Study design: We utilized the 2016-2019 Multistate Pregnancy Risk Assessment Monitoring System (PRAMS) from the Centers for Disease Control. First time parturients who reported depression in the 3 months prior to or at any point during their recent pregnancy were compared to those who did not. Mode of delivery was obtained through the birth certificate. Maternal demographics, pregnancy characteristics and delivery characteristics were compared by report of AD using bivariable analyses. Population-weighted multivariable regression was performed, adjusting for maternal age, race/ethnicity, insurance, pregnancy complications, preterm birth, body mass index. Results: Of the 61,605 people who met the inclusion criteria, 18.3% (n=11,896) reported AD, and 29.8% (n=19,892) underwent CD. Parturients with AD were younger, more likely to be non-Hispanic white, publicly insured, use tobacco in pregnancy, deliver earlier, have lower levels of education, higher BMIs and more medical comorbidities (hypertension and diabetes). After adjustment for these differences, there was no difference in risk of CD between those with AD compared with those without (aRR 1.04, 95% CI 0.97-1.13). Conclusion: In a large, population-weighted, nationally representative sample of first time parturients, there was no association between AD and CD.

Publication History

Received: 07 June 2022

Accepted: 22 September 2022

Accepted Manuscript online:
13 October 2022

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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