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Table 1 Overview of the Included Studies

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

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 +
  1. 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)
  2. * = p ≤ 0.05
  3. ** = p ≤ 0.01
  4. *** = p ≤ 0.001