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Severe obstetric la...
Severe obstetric lacerations associated with postpartum depression among women with low resilience : a Swedish birth cohort study
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- Asif, Sana, M.D, PhD student (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Mulic-Lutvica, Ajlana, 1957- (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Axfors, Cathrine (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Eckerdal, Patricia, 1972- (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Iliadis, Stavros I, 1983- (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Fransson, Emma, PhD, 1973- (author)
- Karolinska Institutet,Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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- Skalkidou, Alkistis, 1977- (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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(creator_code:org_t)
- 2020-05-28
- 2020
- English.
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 127:11, s. 1382-1390
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Abstract
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- OBJECTIVE: Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even self-harm thoughts. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience.DESIGN: Nested cohort study.SETTING: Uppsala, Sweden.SAMPLE: Vaginally delivered women with singleton pregnancies (n = 2,990).METHODS: The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale (SOC-29). A digital acyclic graph (DAG) was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios and 95% confidence intervals. A sub-analysis was run after excluding women with normal or high resilience.MAIN OUTCOME MEASURES: Postpartum depression, assessed with the Depression Self-Reporting Scale (DSRS), completed at six weeks postpartum.RESULTS: There was no significant association between severe obstetric perineal lacerations and PPD at six weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR =4.8 95% CI = 1.2-20), persisting even after adjusting for confounding factors.CONCLUSION: Health care professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- obstetric injuries
- personalised post-natal support
- postpartum depression
- resilience
- severe perineal lacerations
- sphincter injuries
- vacuum extraction
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Asif, Sana, M.D, ...
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Mulic-Lutvica, A ...
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Axfors, Cathrine
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Eckerdal, Patric ...
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Iliadis, Stavros ...
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Fransson, Emma, ...
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show more...
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Skalkidou, Alkis ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
- Articles in the publication
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British Journal ...
- By the university
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Uppsala University
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Karolinska Institutet