Table 4. Symptoms of postpartum depression according to characteristics of mothers and labor and maternal, paternal, and neonatal outcomes in women 6 months after midpelvic or low attempted operative vaginal delivery.
| Postpartum Depression (N = 211) | No-postpartum Depression (N = 603) | P value | |
|---|---|---|---|
| Maternal and labor characteristics | |||
| Maternal age1, (years) | 29.2 ± 5.3 | 29.0 ± 4.6 | 0.61* |
| Multiparity, n (%) | 49 (23.2) | 155 (25.7) | 0.47** |
| BMI ≥ 30 kg/m2 before pregnancy, n (%) | 23 (11.0) | 25 (4.2) | <0.001** |
| Gestational weight gain >20 kg, n (%) | 19 (9.3) | 47 (8.1) | 0.58** |
| Previous postpartum depression, n (%) | 23 (10.9) | 18 (3.0) | <0.001** |
| Gestational age at delivery1 (weeks) | 39.4 ± 1.5 | 39.4 ± 1.4 | 0.99* |
| Length of labor1 (min) | 396.4 ± 169.0 | 390.2 ± 165.4 | 0.64* |
| 2nd stage>3 hours, n (%) | 37 (17.5) | 101 (16.8) | 0.80** |
| Active phase of 2nd stage > 30 min, n (%) | 77 (36.5) | 212 (35.2) | 0.73** |
| Epidural analgesia, n (%) | 201 (95.3) | 576 (95.7) | 0.80** |
| Persistent occiput position, n (%) | 0.15** | ||
| Anterior | 183 (87.1) | 538 (89.5) | |
| Posterior | 17 (8.1) | 50 (8.3) | |
| Transverse | 10 (4.8) | 13 (2.2) | |
| ACOG classification, n (%) | 0.37** | ||
| Mid | 43 (20.4) | 106 (17.6) | |
| Low | 168 (79.6) | 497 (82.4) | |
| Obstetrician performing delivery, n (%) | 0.32** | ||
| Senior obstetrician | 51 (24.8) | 169 (28.3) | |
| Obstetric registrar | 155 (75.2) | 428 (71.7) | |
| Instrument type, n (%) | |||
| Vacuum | 60 (28.4) | 161 (26.7) | 0.63** |
| Forceps | 18 (8.5) | 34 (5.6) | 0.14** |
| Spatula | 140 (66.4) | 421 (69.8) | 0.35** |
| Sequential use of two instruments | 6 (2.8) | 14 (2.3) | 0.67*** |
| Indications for aOVD, n (%) | 0.47** | ||
| Non-reassuring FHR only | 88 (41.7) | 261 (43.3) | |
| Arrested progress only | 84 (39.8) | 248 (41.0) | |
| Non-reassuring FHR and arrested progress | 41 (19.4) | 95 (15.7) | |
| Maternal outcome | |||
| Cesarean delivery after failed operative vaginal delivery, n (%) | 4 (1.9) | 12 (2.0) | 0.93*** |
| Episiotomy, n (%) | 181 (85.8) | 532 (88.4) | 0.32** |
| 3rd or 4th-degree perineal lacerations, n (%) | 6 (2.8) | 20 (3.3) | 0.73** |
| PPH (blood loss>500mL), n (%) | 34 (16.1) | 114 (18.9) | 0.37** |
| Severe PPH (blood loss>1500 mL), n (%) | 6 (2.8) | 14 (2.3) | 0.67*** |
| Abscesses/hematoma requiring surgery, n (%) | 1 (0.5) | 2 (0.3) | 0.77*** |
| Severe maternal morbidity, n (%) | 17 (8.1) | 53 (8.8) | 0.74** |
| Neonatal outcome | |||
| Birth weight > 4000 g, n (%) | 15 (7.4) | 32 (5.3) | 0.33** |
| Neonatal trauma, n (%) | 2 (1.0) | 3 (0.5) | 0.47*** |
| Transfer to NICU, n (%) | 9 (4.3) | 33 (5.5) | 0.49** |
| Severe neonatal morbidity, n (%) | 18 (8.5) | 62 (10.3) | 0.46** |
| Registered variables at 6 months postpartum | |||
| Tobacco (male), n (%) | 71 (43.8) | 180 (37.3) | 0.14** |
| Chronic disease (male), n (%) | 11 (6.8) | 27 (5.6) | 0.57** |
| Breastfeeding, n (%) | 129 (90.8) | 377 (94.0) | 0.20** |
| Pelvic floor muscle training, n (%) | 157 (77.3) | 481 (80.0) | 0.41** |
| Child in the parents’ bedroom during night, n (%) | 19 (11.9) | 54 (11.2) | 0.82** |
| Episiotomy complications, n (%) | 119 (62.0) | 349 (61.9) | 0.98** |
| Perineal pain, n (%) | 36 (17.8) | 73 (12.2) | 0.04** |
| Dyspareunia, n (%) | 69 (37.3) | 177 (31.8) | 0.31** |
| PISQ-12 in sexually active women1 | 34.5 ± 7.9 | 38.1 ± 6.0 | <0.001* |
| IIEF-15 in sexually active men1 | 60.3 ± 14.3 | 64.5 ± 9.2 | <0.001* |
1 Values are given as mean ± standard deviation.
* Student t test,
** χ2 test,
*** Fisher exact test. Statistical significance was defined as a P value < 0.05.