The Relationship of Delivery Mode and Antenatal Fear of Childbirth with Postpartum Depression, Post Traumatic Stress Disorder and Postpartum Fear of Childbirth in Nulliparous Women: A Prospective Longitudinal Study

Background & aim: Diagnosis and treatment of fear of childbirth can influence both delivery mode and postpartum psychological symptoms.  Therefore, the objective of this study was to evaluate postpartum depression, Post Traumatic Stress Disorder (PTSD), and fear of childbirth in nulliparous women based on their delivery mode and antenatal fear of childbirth.Methods: For this prospective longitudinal study, ۱۴۸ Iranian nulliparous women were selected using a convenient sampling method from January to September ۲۰۲۱ in the Mashhad, Iran. The Wijma Delivery Expectancy and Experience Questionnaire (W-DEQ) (A and B versions), the Beck Depression Inventory, and the Perinatal PTSD Questionnaire were administered to collect data. Fear of childbirth was assessed in the last month of pregnancy, followed by evaluation of delivery mode, postpartum depression, PTSD, and fear of childbirth ۴–۶ weeks after delivery. The data were analyzed using analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA), with SPSS version ۲۶.Results: The women in the emergency cesarean group exhibited higher levels of depression and PTSD symptoms compared to those in the vaginal delivery (P<۰.۰۰۰۱) and elective cesarean groups (p=۰.۰۰۳). Postpartum fear of childbirth was more prevalent among women with clinical antenatal fear of childbirth and vaginal delivery than in other women (F (۴, ۱۳۹) = ۲.۸۶, P = ۰.۰۲).Conclusion: The diagnosis and treatment of clinical antenatal fear of childbirth is essential to prevent the worsening of postpartum fear of childbirth. A follow-up program for women with emergency cesarean can help to identify individuals at risk for postpartum depression, PTSD and fear of childbirth.

کلیدواژه ها:

Fear of childbirth ، Postpartum Depression ، Postpartum PTSD ، Mode of Delivery ، Cesarean ، Vaginal delivery