Association between perceived birth trauma and postpartum depression: A prospective cohort study in China

Objective To assess the association between women's perceived birth trauma and risk of postpartum depression (PPD). Methods We conducted a prospective cohort study in China between December 2018 and November 2019. Women aged 18-45 years who had a singleton live birth at a university teaching hospital were enrolled after written consent was obtained. PPD was defined as a score of 13 or more on the Chinese version of the Edinburgh Postnatal Depression Scale. We used multiple log-binomial regression analysis to estimate the independent association between perceived birth trauma and PPD. Results A total of 650 eligible women were included in the final analysis. Of them, 245 (37.69%) had self-reported perceived birth trauma and 188 (28.92%) developed PPD. The PPD rate was 42.04% in women with perceived birth trauma, compared with 20.99% in women without perceived birth trauma (crude relative risk [RR] 2.46, 95% confidence interval [CI] 1.48-3.72). The increased risk of PPD for women with perceived birth trauma remained after adjustment for sociodemographic and obstetric factors (adjusted RR 2.13, 95% CI 1.69-3.28). Conclusion Perceived birth trauma may be an important risk factor for PPD in Chinese women. Supportive care for women who perceived childbirth as a trauma may help to reduce the risk of PPD.