AUTHOR=Sun Ruixue , Zhao Mingzhe , Ma Liangkun , Duan Yanping , Wei Jing 

TITLE=High psychological stress levels related to delivery can increase the occurrence of postpartum mental disorders

JOURNAL=Frontiers in Psychiatry

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1273647

DOI=10.3389/fpsyt.2023.1273647

ISSN=1664-0640

ABSTRACT=<sec id="sec1"><title>Objective</title><p>The study sought to explore the relationship between high psychological stress levels related to delivery and postpartum mental disorders.</p></sec><sec id="sec2"><title>Methods</title><p>A total of 284 parturients were included in the study from July 2021 to January 2022. The stress level at 1 month postpartum was assessed by the Impact of Event Scale-Revised (IES-R). Parturients with an IES-R score ≤ 9 were included in the low psychological stress level group, and those with an IES-R score &gt; 9 were included in the high psychological stress level group. The Edinburgh Postnatal Depression Scale (EPDS), Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70), Symptom Checklist-90 (SCL-90) and Mini-International Neuropsychiatric Interview (M.I.N.I.) were conducted at 42 ± 7 days postpartum to assess the mental health of parturients.</p><p>The parturients’ mental health after birth was assessed by the EPDS, UPPSAQ-70, and SCL-90. Semi-structured diagnostic interviews were conducted at 42 ± 7 days postpartum by using the M.I.N.I.</p></sec><sec id="sec3"><title>Results</title><p>The incidence rate of postpartum mental disorders was 20.42% (58/284), the incidence rates of postpartum depression, anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder were 17.96% (51/284), 11.97% (34/284), 4.58% (13/284) and 1.41% (4/284), respectively, and the comorbidity rate was 58.62% (34/58). A history of mental disorders and pregnancy complications were risk factors for postpartum depression (<italic>p</italic> = 0.028, <italic>p</italic> = 0.040, respectively); a history of mental disorders, a lack of physical exercise, partner violence and pregnancy complications were risk factors for postpartum anxiety disorders (<italic>p</italic> = 0.003, <italic>p</italic> = 0.007, <italic>p</italic> = 0.031, <italic>p</italic> = 0.048, respectively); and the delivery of female infants was a risk factor for postpartum obsessive-compulsive disorder (<italic>p</italic> = 0.022).</p><p>The risk of postpartum depression, anxiety disorders and obsessive-compulsive disorder was 9.125 times (95% CI = 3.900 ~ 21.349, <italic>p</italic> &lt; 0.01), 7.310 times (95% CI = 2.588 ~ 20.649, <italic>p</italic> &lt; 0.01) and 6.259 times (95% CI = 1.347 ~ 29.093, p &lt; 0.01) higher in postpartum women with high psychological stress levels related to delivery than in those with low psychological stress levels, respectively.</p></sec><sec id="sec4"><title>Conclusion</title><p>The incidence of postpartum mental disorders is high and has a positive correlation with the level of psychological stress. This may lead to a new perspective of the effect of psychological stress on postpartum mental disorders and attract more attention to other mental disorders in addition to postpartum depression.</p></sec>