Frequency of Postpartum Depression in Patients Undergoing Caesarean Section: Postpartum Depression in Patients Undergoing Caesarean Section

Sidra Iqbal; Umbreen Akram; Shehzad Bashir Momana; Zubaida Shaheen

doi:10.54393/pjhs.v6i12.3313

Authors

Sidra Iqbal Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan
Umbreen Akram Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan
Shehzad Bashir Momana Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan
Zubaida Shaheen Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i12.3313

Keywords:

Postpartum Depression, Caesarean Section, Socioeconomic Factors, Maternal Health, Neonatal Complications, Mental Health

Abstract

Postpartum depression (PPD) is a common mental health disorder affecting women after childbirth, but its risk varies across clinical and obstetric contexts. However, evidence regarding the association between CS-related maternal, socioeconomic, surgical, and neonatal factors and the development of PPD remains inconsistent. Objectives: To determine the frequency of PPD among women undergoing Caesarean section and its association with education level, socioeconomic status, type of Caesarean section, complications, history of mental health issues, and neonatal complications. Methods: This descriptive cross-sectional study was conducted at the Combined Military Hospital (CMH) Quetta from February 2025 to June 2025. A total of 91 postpartum women who delivered via Caesarean section were included using non-probability consecutive sampling. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of ≥13 to define PPD. Statistical analysis was performed using SPSS version 26.0, and associations between PPD and categorical variables were assessed using the chi-square test. Results: The mean age of participants was 32.14 ± 8.34 years, and the average parity was 2.52±1.68. Postpartum depression was identified in 22 (24%) women. Stratified analysis showed no statistically significant association between PPD and education level (p=0.864), socioeconomic status (p=0.493), type of Caesarean section (p=0.978), complications (p=0.656), history of mental health issues (p=0.794), or neonatal complications (p=0.895). Conclusions: The prevalence of PPD among women undergoing Caesarean section was 24%. However, no significant associations were found with maternal, socioeconomic, surgical, or neonatal factors (all p>0.05). Routine screening and psychological support are essential to address PPD effectively.

Author Biographies

Umbreen Akram, Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan

Umbreen Akram

Cl Gynecologist

CMH Quetta

03314475773

unmbreen_77@hotmail.com

Shehzad Bashir Momana, Department of Obstetrics and Gynecology, National University of Medical Sciences, Rawalpindi, Pakistan

Shehzad Bashir Momana

Assistant professor

Department of Obstetrics and Gynecology

PEMH Rawalpindi

0345 7276908

momina.junaid.gill@gmail.com

References

Suryawanshi IV O and Pajai S. A Comprehensive Review on Postpartum Depression. Cureus. 2022 Dec; 14(12). doi: 10.7759/cureus.32745.

Baba S, Ikehara S, Eshak ES, Ueda K, Kimura T, Iso H. Association Between Mode of Delivery and Postpartum Depression: The Japan Environment and Children’s Study (JECS). Journal of Epidemiology. 2023 May; 33(5): 209-16. doi: 10.2188/jea.JE20210117.

Lin R, Lu Y, Luo W, Zhang B, Liu Z, Xu Z. Risk Factors for Postpartum Depression in Women Undergoing Elective Cesarean Section: A Prospective Cohort Study. Frontiers in Medicine. 2022 Sep; 9: 1001855. doi: 10.3389/fmed.2022.1001855.

Liu TC, Peng HC, Chen C, Chen CS. Mode of Delivery Is Associated with Postpartum Depression: Do Women with and Without Depression History Exhibit A Difference? In Healthcare. 2022 Jul; 10(7): 1308. doi: 10.3390/healthcare10071308.

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global. Regional and National Estimates. 1990; 2014(11): 2. doi: 10.1371/journal.pone.0148343.

Wang R, Liang X, Su XY. Analysis Of Risk Factors for Postpartum Depression After Cesarean Section in Women with Early-Onset Preeclampsia. World Journal of Psychiatry. 2024 Oct; 14(10): 1448. doi: 10.5498/wjp.v14.i10.1448.

O’Neill SM, Kearney PM, Kenny LC, Khashan AS, Henriksen TB, Lutomski JE et al. Caesarean Delivery and Subsequent Stillbirth or Miscarriage: Systematic Review and Meta-Analysis. PLOS One. 2013 Jan; 8(1): e54588. doi: 10.1371/journal.pone.0054588.

Khamidullina Z, Marat A, Muratbekova S, Mustapayeva NM, Chingayeva GN, Shepetov AM et al. Postpartum Depression Epidemiology, Risk Factors, Diagnosis, and Management: An Appraisal of the Current Knowledge and Future Perspectives. Journal of Clinical Medicine. 2025 Apr; 14(7): 2418. doi: 10.3390/jcm14072418.

Yousaf J, Yousaf F, Sana A, Khalid I, Arshad H, Iqbal K. Postpartum Depression Prevalence, Risk Factors, and Interventions among Women in Punjab, Pakistan. Discover Mental Health. 2025 Sep; 5(1): 139. doi: 10.1007/s44192-025-00225-2.

Sun L, Wang S, Li XQ. Association Between Mode of Delivery and Postpartum Depression: A Systematic Review and Network Meta-Analysis. Australian and New Zealand Journal of Psychiatry. 2021 Jun; 55(6): 588-601. doi: 10.1177/0004867420954284.

Dever J and Tischler R. Does Mode of Delivery Influence the Development of Postpartum Depression in Women of Childbearing Age? Evidence-Based Practice. 2024 Feb; 27(2): 18-9. doi: 10.1097/EBP.0000000000001936.

Yousafzai S, Hayat N, Parveen N. Frequency of Postpartum Depression in Operative Vs Spontaneous Vaginal Delivery. Gomal Journal of Medical Sciences. 2024 Apr; 22(2).

Khan MM, Hanan A, Tahir M, Tahir T, Raza SS, Shafique MS. Frequency of Postpartum Depression in Women Attending Fauji Foundation Hospital, Peshawar. Journal of Medical Sciences. 2015 Dec; 23(4): 190-3.

Malik FR, Malik BB, Irfan M. Comparison of Postnatal Depression in Women Following Normal Vaginal Delivery and Caesarean Section: A Pilot Study. Journal of Postgraduate Medical Institute. 2015 May; 29(1).

Selvam G, Balasubramanian J, Chanu SM. Frequency of Postpartum Depression Among Primi Mothers Undergoing Delivery in JIPMER Using Edinburgh Postnatal Depression Scale. New Indian Journal of OBGYN. 2020; 6(2): 106-2. doi: 10.21276/obgyn.2020.6.2.9.

Smithson S, Mirocha J, Horgan R, Graebe R, Massaro R, Accortt E. Unplanned Cesarean Delivery Is Associated with Risk for Postpartum Depressive Symptoms in the Immediate Postpartum Period. The Journal of Maternal-Fetal and Neonatal Medicine. 2022 Oct; 35(20): 3860-6. doi: 10.1080/14767058.2020.1841163.

Kadıoğlu BG, Kamalak Z, Özpolat G, Biçen E. Evaluation of Postpartum Depression Scores of Electives and Emergency Cesarean Section Patients. Journal of Surgery and Medicine. 2020 Feb; 4(2): 139-43. doi: 10.21203/rs.2.14535/v1.

Moameri H, Ostadghaderi M, Khatooni E, Doosti-Irani A. Association of Postpartum Depression and Cesarean Section: A Systematic Review and Meta-Analysis. Clinical Epidemiology and Global Health. 2019 Sep; 7(3): 471-80. doi: 10.1016/j.cegh.2019.02.009.

Dousti R, Hakimi S, Pourfathi H, Nourizadeh R, Sattarzadeh N. Cesarean Section Can Be Related with Postpartum Depression: A Cross-sectional Study. International Journal of Women's Health and Reproduction Sciences. 2022 Oct; 10(4). doi: 10.15296/ijwhr.2022.37.

Doke PP, Vaidya VM, Narula AP, Datar MC, Patil AV, Panchanadikar TM et al. Assessment of Difference in Postpartum Depression Among Caesarean and Vaginally Delivered Women At 6-Week Follow-Up in Hospitals in Pune District, India: An Observational Cohort Study. British Medical Journal Open. 2021 Sep; 11(9): e052008. doi: 10.1136/bmjopen-2021-052008.