Association Between Mode of Birth and Posttraumatic Stress Disorder Following Childbirth: A Prospective Cohort Study of Chinese Women
Bibliographic record
Abstract
Abstract Background Previous studies on the association between mode of delivery and posttraumatic stress disorder have yielded inconsistent results. This study aimed to further investigate the association between mode of delivery and posttraumatic stress disorder in a cohort of Chinese women with a high rate of cesarean delivery.Methods We conducted a prospective cohort study in Guangdong, China between October 2019 and August 2020. Women aged 20-45 years who visited Nanhai Hospital of Southern Medical University for prenatal care and planned to give birth at the same hospital during the study period were approached and were enrolled after a written consent was obtained. Posttraumatic stress disorder was assessed by the Posttraumatic Stress Disorder Checklist-Civilian Version. We first compared the sociodemographic and obstetric characteristics between cesarean delivery group and vaginal delivery group. We then examined the independent association between mode of birth and posttraumatic stress disorder by log binomial regression analysis.Results A total of 630 women were included in the final analysis, with 385 (61%) who delivered vaginally and 245 (39%) who delivered by cesarean section. Fifty-six (8.9%) women developed posttraumatic stress disorder. Of them, 31 (12.7%) occurred in women with cesarean section, and 25 (6.5%) occurred in women with vaginal delivery. The risk of developing posttraumatic stress disorder in women with cesarean section was more than twice of that in women with vaginal delivery after adjusting for confounding variables (adjusted RR 1.91, 95% CI 1.08 to 3.36).Conclusion Cesarean section is an independent risk factor of posttraumatic stress disorder in a cohort of Chinese women with a high cesarean section rate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".