title: Psychiatric illness in women requesting caesarean section.
abstract: OBJECTIVE
  To compare psychiatric in- and outpatient care during the 5 years before first delivery in primiparae delivered by caesarean section on maternal request with all other primiparae women who had given birth during the same time period.
  
  
  METHODS
  Prospective, population-based register study.
  
  
  METHODS
  Sweden.
  
  
  METHODS
  Women giving birth for the first time between 2002 and 2004 (n = 64 834).
  
  
  METHODS
  Women giving birth by caesarean section on maternal request (n = 1009) were compared with all other women giving birth (n = 63 825). The exposure of interest was any psychiatric diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ninth revision, ICD-9, 290-319; tenth revision, ICD-10, F00-F99) in The Swedish national patient register during the 5 years before first delivery.
  
  
  METHODS
  Psychiatric diagnoses and delivery data.
  
  
  RESULTS
  The burden of psychiatric illnesses was significantly higher in women giving birth by caesarean section on maternal request (10 versus 3.5%, P < 0.001). The most common diagnoses were 'Neurotic disorders, stress-related disorders and somatoform disorders' (5.9%, aOR 3.1, 95% CI 1.1-2.9), and 'Mood disorders' (3.4%, aOR 2.4, 95% CI 1.7-3.6). The adjusted odds ratio for caesarean section on maternal request was 2.5 (95% CI 2.0-3.2) for any psychiatric disorder. Women giving birth by caesarean section on maternal request were older, used tobacco more often, had a lower educational level, higher body mass index, were more often married, unemployed, and their parents were more often born outside of Scandinavia (P < 0.05).
  
  
  CONCLUSIONS
  Women giving birth by caesarean section on maternal request more often have a severe psychiatric disease burden. This finding points to the need for psychological support for these women as well as the need to screen and treat psychiatric illness in pregnant women.
authors.affiliation: Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Gynaecology and Obstetrics in Linköping, County Council of Östergötland, Linköping, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Sydsjö
authors.forename: L
authors.initials: L
authors.lastname: Möller
authors.forename: C
authors.initials: C
authors.lastname: Lilliecreutz
authors.forename: M
authors.initials: M
authors.lastname: Bladh
authors.forename: E
authors.initials: E
authors.lastname: Andolf
authors.forename: A
authors.initials: A
authors.lastname: Josefsson
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D009035:Mothers / Q000523:psychology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: Caesarean section; maternal request; mental health; psychiatric diagnoses