The association between depressive symptoms during pregnancy and post-delivery fear of childbirth; a prospective study

ABSTRACT

Background

Fear of childbirth is an important reason for a caesarean section on request.

Objective

To assess the association between depressive symptoms during pregnancy and post-delivery fear of childbirth (PFOC).

Methods

We prospectively studied pregnant women from two hospitals in the Netherlands. Women completed the Edinburgh Depression Scale (EPDS), the Wijma Delivery Experience Questionnaire (W-DEQ B) and questions concerning risk factors. Depressive symptoms were assessed at baseline and six weeks post-delivery. PFOC was assessed six weeks post-delivery. Baseline characteristics and pregnancy outcomes were compared between women with and without a depression at baseline. The association between depression and PFOC was assessed with multivariable logistic regression analysis.

Results

245 women participated in this study. At baseline 11% suffered from depressive symptoms. There were no differences in pregnancy outcomes. Women with depressive symptoms more often suffered from depressive symptoms six weeks post-delivery (adjusted OR 4.9, 95% CI 1.4–17). PFOC six weeks post-delivery was present in 11%. Women with depression were at increased risk of PFOC six weeks post-delivery (adjusted OR 9.2, 95% CI 2.6–32).

Conclusion

This study shows that women with depression at baseline are at increased risk for depression and PFOC six weeks post-delivery.

KEYWORDS:

• Depression
• fear of childbirth
• pregnancy
• post-partum
• psychiatry

Acknowledgments

We thank Linda Meurs, Joey de Vogel, Joyce Cantinau and obstetric counselling nurses of Gelre Hospitals Apeldoorn location for their efforts and help.

Contribution to authorship

MB: coordinating and planning of collecting data in the Amphia hospital Breda, analysing data, writing.

BMK: coordinating and planning of collecting data in Gelre hospital Apeldoorn, analysing data, writing.

DNMP: accompany of study in Amphia hospital, reviewing and criticizing the manuscript

HJZL: statistical assistance

KMP: accompany of study in Gelre hospital Apeldoorn, reviewing and criticizing the manuscript

Details of ethics approval

The Medical Ethical Board of the Gelre Hospitals Apeldoorn location and the Amphia Hospital Breda exempted this study from institutional review board (IRB) approval, since the screening and referral were already part of routine care, now conducted by the Mind2Care instrument, including opting-out. In the Netherlands, screening is allowed under Dutch Law if opting-out is explicit (in Dutch: the WBO and WGBO Act). De-identified data from patients’ medical records were used in post-hoc analyses.

Disclosure statement

No potential conflict of interest was reported by the authors.

Geolocation information

Our study was set in Apeldoorn and Breda, two cities in the Netherlands

Supplementary material

Supplemental data for this article can be accessed here.