Epidural Labor Analgesia Is Associated with a Decreased Risk of the Edinburgh Postnatal Depression Scale in Trial of Labor after Cesarean: A Multicenter, Prospective Cohort Study
Table 4
Univariate and multivariate analysis of PPD in TOLAC 48 hours after delivery.
Variable
Univariate
Multivariate (n = 369)
Independent
value
OR (95% CI)
value
OR (95% CI)
Epidural analgesia
<0.001
0.259 (0.145–0.449)
<0.001
0.209 (0.096–0.429)
Hospital name
MCH
1 (reference)
BA
0.705
0.862 (0.377–1.785)
0.224
1.941 (0.638–5.561)
LG
0.049
0.299 (0.071–0.856)
0.069
0.286 (0.060–0.975)
General information
Age (year)
0.816
0.992 (0.923–1.066)
Gestational age (day)
0.253
1.017 (0.991–1.050)
BMI (kg/m2)
0.38
0.958 (0.869–1.049)
Maternal education >12 y
0.301
0.736 (0.416–1.338)
Husband education >12 y
0.235
0.694 (0.386–1.293)
Housewives
0.713
1.190 (0.430–2.821)
Family income (¥/mo)
≤10,000
1 (reference)
10,001–20,000
0.057
0.475 (0.222–1.039)
>20,000
0.011
0.382 (0.183–0.817)
History of depression and trauma
0.086
5.645 (0.667–47.762)
Impact of childbirth on work or re-employment
0.456
1.476 (0.475–3.838)
Maternity leave time
No
1 (reference)
Legal time
0.987
2517827.629 (0.000–NA)
Full-time
0.987
3841697.685 (0.000–NA)
Anxiety and depression during pregnancy
0.115
1.543 (0.896–2.642)
Cigarettes, alcohol, long-term medication
0.408
2.770 (0.128–29.334)
Whether the husband is satisfied with the baby’s sex
0.187
2.259 (0.781–9.581)
Caring health knowledge during pregnancy
① Routine obstetric examination
0.287
0.531 (0.178–1.948)
② Attend maternity classes
0.062
0.581 (0.323–1.015)
③ Learn about parenting through cell phones or books
0.354
0.720 (0.369–1.498)
Unplanned pregnancy
0.052
1.706 (0.992–2.923)
Whether the maternal is the only child in one’s family
0.743
1.138 (0.497–2.367)
Changes in marital relationship during pregnancy
0.05
11.226 (1.060–243.732)
SAS
<0.001
1.092 (1.045–1.142)
0.003
1.093 (1.031–1.162)
SSRS
<0.001
0.895 (0.858–0.932)
0.004
0.932 (0.887–0.977)
MMSE
0.377
1.118 (0.872–1.431)
Prepartum Laboratory test
HGB (g/L: 115–150)
0.085
1.017 (0.998–1.037)
PLT (125–350)
0.002
0.992 (0.987–0.997)
0.017
0.992 (0.986–0.998)
Initiating lactation period (hours)
0.273
1.011 (0.990–1.030)
Delivery outcome
Mode of delivery (Cesarean VS VBAC)
0.503
1.242 (0.640–2.297)
Episiotomy
0.278
0.718 (0.387–1.289)
Perineum/Cervical laceration
0.01
2.128 (1.209–3.808)
0.119
1.715 (0.873–3.411)
Feeding patterns within 48 hours (milk VS breast)
0.169
0.241 (0.013–1.191)
Feeding amounts within 48 hours (Abnormal VS normal)
0.747
0.814 (0.187–2.500)
Neonatal weight ≥ 3500
0.086
1.680 (0.916–3.003)
Admission to neonatal ward after birth
0.324
0.541 (0.127–1.587)
BMI: body mass index; VAS: visual analog scale; SAS: Self-Rating Anxiety Scale; SSRS: Social Support Rating Scale; MMSE: mini-mental state examination; HGB: hemoglobin; PLT: platelet; ¥: Chinese Yuan. Hosmer and Lemeshow goodness of fit (GOF) test; X-squared (χ2) = 8.476, df = 8, value = 0.388. McFadden’s pseudo-R squared = 0.206. Cox and Snell pseudo-R squared = 0.157. Nagelkerke pseudo-R squared = 0.279.