Association between mode of delivery and postpartum depression among primiparous women: a prospective follow-up study

Mode of delivery has been proposed as a potential risk factor for postpartum depression (PPD); however, findings from previous studies have been inconsistent. This study investigated the association between mode of delivery and PPD among primiparous women. This prospective follow-up study included 254 primiparous women who attended health-related service centers in Kermanshah, Iran, in 2023. Participants were recruited using a multistage sampling strategy during the early postpartum period and were assessed at 6 weeks postpartum and followed up at 12 weeks postpartum. Demographic and obstetric characteristics were collected using a structured questionnaire. At 6 weeks postpartum, 52 women (20.5%) met the DSM-5 diagnostic criteria for PPD, whereas 35 women (13.8%) met the diagnostic criteria at 12 weeks postpartum. After adjustment for potential confounders, mode of delivery was not statistically significantly associated with PPD at either 6 or 12 weeks postpartum. In subgroup analyses, among women who underwent cesarean delivery, the absence of a history of abortion was associated with lower odds of PPD at 6 weeks postpartum (OR = 0.304; 95% CI: 0.122–0.757). Among women who had vaginal delivery, unintended pregnancy was associated with higher odds of PPD at 6 weeks postpartum (OR = 7.740; 95% CI: 2.436–24.591). At 12 weeks postpartum, marital dissatisfaction (OR = 23.890; 95% CI: 2.264–252.080) and unintended pregnancy (OR = 4.083; 95% CI: 1.279–13.033) were associated with higher odds of PPD among women who had vaginal delivery. No, statistically significant association between mode of delivery and postpartum depression was observed at either 6 or 12 weeks postpartum after adjustment for relevant covariates.