title: Cohort study of the depression, anxiety, and anhedonia components of the Edinburgh Postnatal Depression Scale after delivery.
abstract: OBJECTIVE
  To investigate the applicability of the Edinburgh Postnatal Depression Scale (EPDS) for identifying depressive symptoms following vaginal or cesarean delivery.
  
  
  METHODS
  The present observational study included consecutive Italian-speaking women who underwent vaginal or cesarean deliveries of uncomplicated singleton pregnancies at term at Policlinico Abano Terme, Abano Terme, Italy, between February 1, 2014, and May 31, 2015, who completed the EPDS 2 days after delivery. EPDS scores and the depression, anxiety, and anhedonia subscale items were compared between delivery methods to identify factors predictive of high EPDS scores.
  
  
  RESULTS
  There were 950 patients included in the analysis; 694 (73.1%) and 256 (26.9%) patients underwent vaginal and cesarean deliveries, respectively. Total EPDS scores were higher among patients who had cesarean deliveries compared with vaginal deliveries (6.95±4.80 vs 6.05±4.20; P=0.007); the depression (0.53±0.72 vs 0.37±0.65; P=0.007), anxiety (1.07±0.88 vs 1.16±0.93; P=0.021), and anhedonia (0.32±0.59 vs 0.19±0.48; P=0.009) subscale scores were all higher among patients who underwent cesarean deliveries.
  
  
  CONCLUSIONS
  Women who underwent cesarean deliveries demonstrated higher EPDS scores and could be at increased risk of developing early postpartum depressive symptomatology, particularly anhedonia, anxiety, and depression.
authors.affiliation: Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Zanardo
authors.affiliation: Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Giliberti
authors.affiliation: Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Volpe
authors.affiliation: Department of Anesthesia, University of Toronto, Toronto, ON, Canada.
authors.forename: Matteo
authors.initials: M
authors.lastname: Parotto
authors.affiliation: Division of Social Statistics and Demography, University of Southampton, Southampton, UK.
authors.forename: Federico
authors.initials: F
authors.lastname: de Luca
authors.affiliation: Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Straface
mesh_terms: D000328:Adult; D059445:Anhedonia; D001007:Anxiety / Q000175:diagnosis*; D001008:Anxiety Disorders / Q000175:diagnosis; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000523:psychology; D003863:Depression / Q000175:diagnosis*; D019052:Depression, Postpartum / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D012720:Severity of Illness Index
keywords: Anhedonia; Anxiety; Delivery mode; Depression subscales; Edinburgh Postnatal Depression Scale; Postpartum depressive symptomatology