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 6
Univariate and multivariate analysis of PPD in TOLAC 42 days after delivery.
Variable
Univariate
Multivariate (n = 386)
Independent
value
OR (95% CI)
value
OR (95% CI)
Epidural analgesia
<0.001
0.210 (0.112–0.380)
<0.001
0.235 (0.113–0.469)
Hospital name
MCH
1 (reference)
BA
0.49
0.742 (0.293–1.638)
LG
0.078
0.337 (0.080–0.970)
General information
Age (year)
0.764
1.012 (0.938–1.092)
Gestational age (day)
0.413
1.012 (0.987–1.045)
BMI (kg/m2)
0.306
0.949 (0.855–1.044)
Maternal education >12 y
0.714
0.890 (0.484–1.702)
Husband education >12 y
0.683
0.873 (0.464–1.728)
Housewives
0.499
1.378 (0.496–3.287)
Family income (¥/mo)
≤10,000
1 (reference)
10,001–20,000
0.45
0.715 (0.307–1.774)
>20,000
0.26
0.618 (0.275–1.494)
History of depression and trauma
0.065
6.473 (0.764–54.851)
Impact of childbirth on work or re-employment
0.309
1.705 (0.547–4.456)
Maternity leave time
No
1 (reference)
Legal time
0.775
0.731 (0.119–14.063)
Full-time
0.719
1.486 (0.240–28.690)
Anxiety and depression during pregnancy
0.018
1.979 (1.125–3.487)
Cigarettes, alcohol, long-term medication
0.35
3.170 (0.146–33.618)
Whether the husband is satisfied with the baby’s sex
0.276
1.963 (0.676–8.341)
Caring health knowledge during pregnancy
① Routine obstetric examination
0.881
1.122 (0.303–7.273)
② Attend maternity classes
0.254
0.713 (0.392–1.264)
③ Learn about parenting through cell phones or books
0.314
1.581 (0.695–4.270)
Unplanned pregnancy
0.027
1.891 (1.074–3.329)
Whether the maternal is the only child in one’s family
0.939
0.968 (0.382–2.142)
Changes in marital relationship during pregnancy
0.038
12.873 (1.214–279.754)
SAS
0.001
1.079 (1.031–1.130)
0.097
1.051 (0.991–1.114)
SSRS
<0.001
0.922 (0.885–0.961)
0.017
0.945 (0.901–0.990)
MMSE
0.991
0.998 (0.768–1.293)
Prepartum Laboratory test
HGB (g/L: 115–150)
0.015
1.027 (1.006–1.051)
0.08
1.027 (0.997–1.058)
PLT (125–350)
0.111
0.996 (0.990–1.001)
Initiating lactation period (hours)
0.104
1.016 (0.996–1.036)
Delivery outcome
Mode of delivery (Cesarean VS VBAC)
0.401
1.325 (0.667–2.503)
Episiotomy
0.34
0.735 (0.382–1.362)
Perineum/Cervical laceration
0.015
2.121 (1.166–3.931)
0.076
1.850 (0.942–3.689)
Feeding patterns within 48 hours (milk VS breast)
0.234
1.887 (0.597–5.055)
Feeding amounts within 48 hours (Abnormal VS normal)
0.474
0.581 (0.091–2.080)
Neonatal weight ≥ 3500
0.296
1.403 (0.727–2.603)
Admission to neonatal ward after birth
0.451
0.625 (0.146–1.839)
Discomfort within 42 days
<0.001
7.692 (4.108–14.466)
<0.001
5.934 (2.823–12.524)
Hosmer and Lemeshow goodness of fit (GOF) test; X-squared (χ2) = 10.156, df = 8, value = 0.254. McFadden’s pseudo-R squared = 0.230. Cox and Snell pseudo-R squared = 0.162. Nagelkerke pseudo-R squared = 0.302.