Background: Whether or not cesarean delivery is associated with increased risk of postpartum depression (PPD) remains unclear.
Methods: We carried out a prospective cohort study between February and September 2007 in Hunan Maternal and Infant Hospital and the First Affiliated and Third Affiliated Hospitals of the Central South University in Changsha, Hunan, People's Republic of China. The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to assess PPD, with a score of ≥13 as the cutoff for PPD.
Results: A total of 534 women were included in the final analysis, with 415 (77.7%) delivering by cesarean section (the majority of them with no medical indication). The rate of PPD was 21.7% in women who had a cesarean delivery and 10.9% in women who delivered vaginally. The increased risk of PPD in women who had cesarean sections was maintained after we adjusted for potential confounding factors or considered cesarean delivery by social indications.
Conclusions: Cesarean section is associated with increased risk of PPD in Chinese women with a high cesarean delivery rate.