The association between depressive symptoms during pregnancy and post-delivery fear of childbirth; a prospective study

Background: Fear of childbirth is an important reason for a caesarean section on request. Objective: To assess the association between depressive symptoms during pregnancy and post-delivery fear of childbirth (PFOC). Methods: We prospectively studied pregnant women from two hospitals in the Netherlands. Women completed the Edinburgh Depression Scale (EPDS), the Wijma Delivery Experience Questionnaire (W-DEQ B) and questions concerning risk factors. Depressive symptoms were assessed at baseline and six weeks post-delivery. PFOC was assessed six weeks post-delivery. Baseline characteristics and pregnancy outcomes were compared between women with and without a depression at baseline. The association between depression and PFOC was assessed with multivariable logistic regression analysis. Results: 245 women participated in this study. At baseline 11% suffered from depressive symptoms. There were no differences in pregnancy outcomes. Women with depressive symptoms more often suffered from depressive symptoms six weeks post-delivery (adjusted OR 4.9, 95% CI 1.4–17). PFOC six weeks post-delivery was present in 11%. Women with depression were at increased risk of PFOC six weeks post-delivery (adjusted OR 9.2, 95% CI 2.6–32). Conclusion: This study shows that women with depression at baseline are at increased risk for depression and PFOC six weeks post-delivery.