Depression and anxiety may be related to the risk of pregnant women's caesarean section

Perinatal mood and anxiety disorders have been associated with adverse pregnancy outcomes such as low birth weight and premature delivery

"Our findings emphasize the importance of better identifying and treating perinatal depression and anxiety disorders in pregnant women," said senior author Vanessa Dalton, MD, master of public health, obstetrician and gynecologist at the University of Michigan Health Von Voigtlander and Women's Hospital

"It is important to better understand how these emotional disorders increase the likelihood of a C-section.

Researchers analyzed the data of 360,225 childbirth and hospitalizations of commercial insurance women aged 15-44 between 2008 and 2017, of which 24% included the first caesarean section

This study is one of the largest studies documenting the relationship between early mood and anxiety disorders in low-risk pregnant women and the first Caesarean section

In the United States, as many as one-fifth of women of childbearing age are affected by perinatal mood and anxiety disorders.

Dalton said: "More and more people realize that mental health during pregnancy is really important

Dalton said that anxiety and depression have many other negative effects on women and their children, including unfavorable delivery outcomes, higher maternal morbidity and loss of income

The author points out that the estimated cost of untreated perinatal mood and anxiety disorders in the United States from pregnancy to the first five years of the child’s life is more than 14 billion U.

The risks of caesarean section surgery

Reducing the rate of first Caesarean section is the goal of "Health 2030" in the United States, which has been supported by many public health and professional organizations

Like any major surgery, there are some risks associated with a Caesarean section, including the risk of blood clots, bleeding, infection, and future pregnancy

Dalton said: "Cesarean section is a major factor in postpartum morbidity after childbirth, and there are many adverse downstream effects

The author points out that the goal of healthy people is to reduce the number of caesarean sections by 2.

Compared with women without perinatal mood and anxiety disorders, women with these disorders are more likely to be older, white, and have a family income of more than 400% of poverty

Although the reason for this relationship is speculative, there are also unproven theories, including the notion that prenatal anxiety is sometimes concentrated on the delivery itself, which may prompt providers to switch to caesarean section to reduce the delivery process

Dalton said, but these speculations have not been confirmed, and further research is needed to understand this association

She said: “We need more research to clarify the relationship between perinatal mood and anxiety disorders and primary cesarean section rates to enhance our understanding of the consequences of these disorders on health outcomes

Journal Reference :

1. Melissa K.
   Zochowski, Giselle E.
   Kolenic, Kara Zivin, Anca Tilea, Lindsay K.
   Admon, Stephanie V.
   Hall, Agatha Advincula, Vanessa K.
   Dalton.
   Trends In Primary Cesarean Section Rates Among Women With And Without Perinatal Mood And Anxiety Disorders .
   Health Affairs , 2021; 40 (10): 1585 DOI: 10.
   1377/hlthaff.
   2021.
   00780