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The synergistic effect of breastfeeding discontinuation and cesarean section delivery on postpartum depression: A nationwide population-based cohort study in Korea

Authors
 Jin Young Nam  ;  Young Choi  ;  Juyeong Kim  ;  Kyoung Hee Cho  ;  Eun-Cheol Park 
Citation
 JOURNAL OF AFFECTIVE DISORDERS, Vol.218 : 53-58, 2017 
Journal Title
 JOURNAL OF AFFECTIVE DISORDERS 
ISSN
 0165-0327 
Issue Date
2017
MeSH
Adult ; Breast Feeding*/psychology ; Cesarean Section/psychology* ; Cohort Studies ; Delivery, Obstetric/psychology* ; Depression, Postpartum/etiology* ; Female ; Humans ; Parturition ; Postpartum Period ; Pregnancy ; Psychiatric Status Rating Scales ; Republic of Korea ; Young Adult
Keywords
Breastfeeding discontinuation ; Cesarean section ; Postpartum depression
Abstract
BACKGROUND: The relationships between breastfeeding discontinuation and cesarean section delivery, and the occurrence of postpartum depression (PPD) remain unclear. Therefore, we aimed to investigate the association of breastfeeding discontinuation and cesarean section delivery with PPD during the first 6 months after delivery. METHODS: Data were extracted from the Korean National Health Insurance Service-National Sample Cohort for 81,447 women who delivered during 2004-2013. PPD status was determined using the diagnosis code at outpatient or inpatient visit during the 6-month postpartum period. Breastfeeding discontinuation and cesarean section delivery were identified from prescription of lactation suppression drugs and diagnosis, respectively. Cox proportional hazards models were used to calculate adjusted hazard ratios. RESULTS: Of the 81,447 women, 666 (0.82%) had PPD. PPD risk was higher in women who discontinued breastfeeding than in those who continued breastfeeding (hazard ratio=3.23, P<0.0001), in women with cesarean section delivery than in those with vaginal delivery (hazard ratio=1.26, P=0.0040), and in women with cesarean section delivery who discontinued breastfeeding than in those with vaginal delivery who continued breastfeeding (hazard ratio=4.92, P<0.0001). LIMITATIONS: Study limitations include low PPD incidence; use of indirect indicators for PPD, breastfeeding discontinuation, and working status, which could introduce selection bias and errors due to miscoding; and potential lack of adjustment for important confounders. CONCLUSIONS: Breastfeeding discontinuation and cesarean section delivery were associated with PPD during the 6-month postpartum period. Our results support the implementation of breastfeeding promoting policies, and PPD screening and treatment programs during the early postpartum period.
Full Text
http://www.sciencedirect.com/science/article/pii/S0165032716323941
DOI
10.1016/j.jad.2017.04.048
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Nam, Jin Young(남진영)
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154603
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