title: Cesarean section and postpartum depression in a cohort of Chinese women with a high cesarean delivery rate.
abstract: 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.
authors: OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Canada.
authors: Ri-hua
authors: RH
authors: Xie
authors: Jun
authors: J
authors: Lei
authors: Shuhong
authors: S
authors: Wang
authors: Haiyan
authors: H
authors: Xie
authors: Mark
authors: M
authors: Walker
authors: Shi Wu
authors: SW
authors: Wen
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data*; D002681:China; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D011181:Postnatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012944:Social Support; D016387:Women's Health; D055815:Young Adult