Psychosocial predictors of disappointment with delivery and puerperal depression - A longitudinal study

Background. To examine the extent to which personality characteristics, dep ression, fear and anxiety about pregnancy and delivery, and socio-economic background, predict disappointment with delivery and the risk of puerperal depression. Methods. Two hundred and eleven women filled in questionnaires measuring pe rsonality traits, socio-economic Factors, and marital satisfaction once bef ore and once after the 30th week of pregnancy, and 2-3 months after deliver y, when obstetric data about pregnancy and delivery was also collected. Results. The women who were disappointed with their delivery or suffered fr om puerperal depression had been more depressed already in Parry pregnancy. Regression analysis showed that the strongest predictors of disappointment with delivery were labor pain (increase in R-2=0.14, p<0.001) and emergenc y Cesarean (increase in R-2=0.18, p<0.001). Puerperal depression was predicted by depression (increase in R-2=0.16, p<0 .001), and by personal traits such as general anxiety, vulnerability and ne uroticism (increase in R-2=0.32, p<0.001), both before 30 weeks of pregnanc y and prior to the delivery (for depression increase in R-2=0.05, p<0.001, and for anxiety and vulnerability increase in R-2=0.04, p<0.01). The strong est predictors were depression at both time points before delivery (beta=0. 51, p<0.001, and beta = 0.39, p<0.001). Pregnancy- and delivery-related anx iety prior to the delivery also predicted puerperal depression, but complic ations of the pregnancy and delivery did not. Conclusions. Depression in early pregnancy predicts disappointment with the delivery and is a strong predictor of puerperal depression.