Analysis of risk factors for postpartum depression after cesarean section in women with early-onset preeclampsia

Table 1 Comparison of baseline data among postpartum depression and non-postpartum depression groups, n (%)

Variable	PPD (n = 60)	Non-PPD (n = 227)	P value
Mean age (years, SD)	32.5 ± 4.2	31.8 ± 5.1	0.329
Ethnicity	Chinese (100)	Chinese (100)	/
Parity
Nulliparous	27	90	0.453
Multiparous	33	137
Maternal age (years)
≤ 40	36 (60.0)	186 (81.9)	< 0.001
> 40	24 (40.0)	41 (18.1)
Obesity pre-pregnancy ≥ 30.0 kg/m2
Yes	15	193	< 0.001
No	45	34
Smoking during pregnancy
Yes	3	2	0.811
No	57	225
Marital status
Married	55	208	0.935
Single or divorced	5	19
Previous preeclampsia
Yes	34	11	< 0.001
No	26	216
Medical payment
Medical insurance	52	196	0.198
Self-paying	8	31
Maternal comorbidities
Gestational diabetes mellitus	11 (18.3)	20 (8.8)	0.035
Preexisting hypertension	3 (5.0)	37 (16.3)	0.025
Antenatal self-rating anxiety scale (median, IQR)	35.0 (7.5)	31.0 (6.5)	< 0.001
Antenatal self-rating depression scale (median, IQR)	33.0 (11.0)	30.0 (9.0)	< 0.001
Antenatal social support rating scale	4 (6.5)	20 (9.0)	0.761
Fear of childbirth week 32 (Wijma Delivery Expectancy/Experience Questionnaire Version A)
Low score (< 85)	8	30	0.782
High score (≥ 85)	52	197
Postpartum variables at 2 days
Pain of uterine contraction	4 (68.3)	12 (53.3)	0.037
Pain from surgical scar	50 (83.3)	160 (70.5)	0.046
Numeric rating scale for pain of uterine contraction (mean, SD)	2.9 (2.5)	2.7 (2.4)	0.321
EPDS score (median, IQR)	4.1 (5.0)	3.2 (3.1)	0.004
Postpartum depressive symptoms			< 0.001
Edinburgh Postnatal Depression Scale ≥ 11
Postpartum variables at 6 weeks
Pains at 6 weeks postpartum	30 (50.0)	61 (26.9)	< 0.001
Pain impacting daily activities	16 (26.7)	29 (12.8)	< 0.001
Pain disturbing sleep quality	11 (18.3)	18 (7.9)	< 0.001
Need for pain medication	5 (8.3)	9 (4.0)	0.037

PPD: Postpartum depression; IQR: Interquartile range.

Table 2 Risk factors for postpartum depression after cesarean section in women with early-onset preeclampsia

Variable	P value	Odds ratio	95%CI
Age > 40 years old	< 0.001	1.93	1.31-2.82
Pre-pregnancy obesity	0.048	2.42	1.62-3.63
Previous preeclampsia	0.016	7.15	5.81-8.85
Gestational diabetes mellitus	0.032	3.52	2.51-4.92
Preexisting hypertension	< 0.001	1.35	1.03-1.89
Antenatal self-rating anxiety scale	0.036	1.13	1.06-1.18
Antenatal self-rating depression scale	0.93	1	0.96-1.05
Postpartum variables at 2 days
Pain of uterine contraction	0.19	1.33	0.86-2.05
Pain from surgical scar	0.06	2.08	0.96-4.32
EPDS score	0.45	1.06	0.91-1.18
Postpartum depression (EPDS ≥ 11)	0.03	6.15	1.32-28.35
Postpartum variables at 6 weeks
Pains at 6 weeks postpartum	0.04	2.16	1.28-3.66
Pain impacting daily activities	0.46	1.37	0.62-2.65
Pain disturbing sleep quality	0.97	1.03	0.47-2.28
Need for pain medication	0.98	0.96	0.35-2.42

EPDS: Edinburgh Postnatal Depression Scale.