The role of elective and emergency cesarean delivery in maternal postpartum anhedonia, anxiety, and depression

Objective: To compare levels of anhedonia, anxiety, and depression in women following elective and emergency cesarean delivery. Methods: An observational study was conducted between January 1, 2015, and May 31, 2017, among Italian women who delivered healthy neonates at term at the Policlinico Abano Terme, Italy, by vaginal, elective cesarean delivery (ElCD) or emergency cesarean (EmCD) delivery. The women completed the Edinburgh Postnatal Depression Scale (EPDS), including specific factors within each category, 2 days post-delivery to measure postpartum depressive symptomatology. Results: Of the 2234 women enrolled in the study, 1702 (76.2%) had a vaginal delivery and 532 (23.8%) a cesarean delivery, of which 264 (11.8%) were emergency and 268 (12.0%) were elective. Mean EPDS scores (P=0.075) and the number of women with EPDS scores >12 (P=0.718) were comparable among the delivery groups. However, mean anxiety factor scores were significantly higher in the ElCD group (P=0.031), and conversely, mean anhedonia factor scores were significantly higher in the EmCD group (P=0.001). Conclusion: Postpartum depressive symptomatology of women who have had a cesarean delivery was characterized by higher levels of anxiety after ElCD and by higher levels of anhedonia after EmCD.