There is an association between emergency caesarean section and post-partum depression (OR 1.47, 1.33-1.62).

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• Hui Xu, Yu Ding, Yue Ma, Xueling Xin, and Dongfeng Zhang.
• Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China. Electronic address: xuhui715@126.com.
• J Psychosom Res. 2017 Jun 1; 97: 118-126.

ObjectiveThe association of cesarean section (CS) with the risk of postpartum depression (PPD) remains controversial. Therefore, we conducted a meta-analysis to explore the association between CS and the risk of PPD.MethodsA systematic literature search was performed in PubMed, Web of Science and Embase databases for relevant articles up to November 2016. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with fixed-effects model or random-effects model.ResultsA total of 28 studies from 27 articles involving 532,630 participants were included in this meta-analysis. The pooled OR of the association between CS and PPD risk was 1.26 (95% CI: 1.16-1.36). In subgroup analyses stratified by study design [cohort studies: (1.25, 95% CI: 1.10-1.41); case-control studies: (1.25, 95% CI: 1.00-1.56); cross-sectional studies: (1.44, 95% CI: 1.14-1.82)] and adjustment status of complications during pregnancy [adjusted for: (1.29, 95% CI: 1.12-1.48); not-adjusted for: (1.24, 95% CI: 1.13-1.36)], the above-mentioned associations remained consistent. The pooled ORs of PPD were 1.15 (95% CI: 0.92-1.43) for elective cesarean section (ElCS) and 1.47 (95% CI: 1.33-1.62) for emergency cesarean section (EmCS).ConclusionThis meta-analysis suggests that CS and EmCS increase the risk of PPD. Further evidence is needed to explore the associations between the specific types of CS and the risk of PPD.Copyright © 2017 Elsevier Inc. All rights reserved.

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