Is cesarean section a clinical marker for psychiatric and sleep disorder in young mothers? A cross-sectional study from rural South India

BACKGROUND: Gestation and postnatal period are important stages in a woman’s life. The type of delivery, vaginal delivery (VD) or cesarean Section (CS), is determined by maternal and fetal factors and their mutual fit. The type of delivery has consequences on the health and well-being of the mother and the newborn. Postpartum psychiatric disorders have been found to be both positively and negatively associated with the mode of delivery and demographic and clinical variables of the postpartum mothers. In view of the foregoing, a comprehensive investigation of the demographic and clinical variables and a range of psychiatric disorders among postpartum women delivered both vaginally and by CS in a rural tertiary care hospital in South India was proposed. MATERIALS AND METHODS: All consecutive women delivered vaginally and by CS attending Maternal and Child Clinic within 42 days of delivery were approached. Following informed consent and application of inclusion and exclusion criteria, 121 women delivered vaginally and 124 women delivered by CS were assessed using Mini International Neuropsychiatric Interview (MINI) and Pittsburgh Sleep Quality Index (PSQI). The data obtained were entered into MS Excel 2010 version and further analyzed using STATA v13. RESULTS: Both groups were matched on most demographic and clinical variables except age and whether pregnancy was planned or not. Postpartum depression was the most frequent diagnosis in both groups, with significantly more cases following CS compared to VD. Other psychiatric disorders were also found to be more following CS. The quality of sleep (QOS) was significantly poor following CS. QOS was significantly poor in the presence of a coexisting psychiatric disorder. CONCLUSION: This study has limitations in terms of being cross-sectional and disability being defined by cutoff scores on MINI and PSQI.