The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review

Table 1 Overview of the Included Studies

First Author (Year) Country	N	Design	Anxiety and/or depression scale	Follow-up	Results	Quality Appraisal (Newcastle Ottawa Scale)
Adams [16] (2011) Norway	(wish for) ECS = 5,352 VAG = 50,462	Cohort	SCL-8	30wk preg 6 mnth PP	Anxiety and depression scores ECS > VAG (AP and PP) ^*. Difference PP is not significant anymore when adjusted for SCL-8 score AP.	8 stars (very good) Selection ++++ Comparability ++ Outcome ++
Garthus-Niegel [36] (2014) Norway	Prefer ECS, get VAG = 112 Prefer ECS, get ECS = 53 Normal VAG = 1,493	Cohort	WDEQ SCL-Anxiety IES EPDS	17wk preg 32wk preg 8wk PP	Women who prefer ECS but deliver vaginally have; Higher depression and anxiety scores AP * Higher post-traumatic stress PP ^* and PPD ** compared to women without preference for ECS who deliver vaginally	7 stars (good) Selection ++++ Comparability ++ Outcome +
Wiklund [14] (2007) Sweden	(wish for) ECS = 91 VAG = 266	Cohort	EPDS	2 days PP 3mnth PP	PPD ECS = VAG	4 stars (satisfactory) Selection +++ Comparability - Outcome +

AP antepartum, ECS elective cesarean section, EPDS Edinburgh Postnatal Depression Scale, IES Impact of Event Scale (measures PTSD), mnth months, preg pregnancy, PP postpartum, PPD postpartum depression scores, SCL-Anxiety (Hopkins) Symptom-Checklist (measures anxiety), SCL-8 (Hopkins) Symptom-Checklist-8 (measures anxiety and depression), VAG vaginal delivery, wk weeks, WDEQ Wijma Delivery Expectancy/Experience Questionnaire (measures childbirth fear)
* = p ≤ 0.05
** = p ≤ 0.01
*** = p ≤ 0.001

ISSN: 1471-2393