Cesarean effects on adolescents’ birth experiences: counterfactual analysis

INTRODUCTION: The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. OBJECTIVE: To ascertain whether a cesarean birth mediates the impact of infant complicati...

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Autores principales: Connolly, John P., Anderson, Cheryl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Psiquiatria do Rio Grande do Sul 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879090/
https://www.ncbi.nlm.nih.gov/pubmed/32844980
http://dx.doi.org/10.1590/2237-6089-2019-0102
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author Connolly, John P.
Anderson, Cheryl
author_facet Connolly, John P.
Anderson, Cheryl
author_sort Connolly, John P.
collection PubMed
description INTRODUCTION: The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. OBJECTIVE: To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. METHODS: Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. RESULTS: We found that the mediating effect of delivery mode depended on the adolescent’s depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. CONCLUSION: Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.
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spelling pubmed-78790902021-03-02 Cesarean effects on adolescents’ birth experiences: counterfactual analysis Connolly, John P. Anderson, Cheryl Trends Psychiatry Psychother Article INTRODUCTION: The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. OBJECTIVE: To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. METHODS: Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. RESULTS: We found that the mediating effect of delivery mode depended on the adolescent’s depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. CONCLUSION: Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized. Associação de Psiquiatria do Rio Grande do Sul 2020-08-14 /pmc/articles/PMC7879090/ /pubmed/32844980 http://dx.doi.org/10.1590/2237-6089-2019-0102 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Connolly, John P.
Anderson, Cheryl
Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title_full Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title_fullStr Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title_full_unstemmed Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title_short Cesarean effects on adolescents’ birth experiences: counterfactual analysis
title_sort cesarean effects on adolescents’ birth experiences: counterfactual analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879090/
https://www.ncbi.nlm.nih.gov/pubmed/32844980
http://dx.doi.org/10.1590/2237-6089-2019-0102
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