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However, existing studies have been limited by the use of depression screening tools as outcomes, and none to date have used a structured clinical interview for DSM-V (SCID), which is considered the gold standard for psychiatric diagnoses. This study aimed to quantify the relationships between labor and postpartum pain and postpartum depression diagnosis detected by SCID, as well as depression symptoms detected by the Center for Epidemiological Studies Depression Scale (CESD) screening tool, among a high-risk cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study was a secondary analysis of a prospective observational study of a cohort of women enriched for high risk for depression, i.e., pregnant women originally enrolled in a prospective study investigating factors leading to excessive gestational weight gain. Subjects were assessed prospectively for depression using both SCID and CESD at the third trimester and at 6\u00a0months postpartum. Overweight and obesity were defined as pre-gravid body mass index (BMI)\u2009\u2265\u200925\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Both vaginal and cesarean deliveries were included in the cohort. Pain scores (0\u201310 numeric rating scale) during childbirth and after delivery were correlated with CESD and SCID. Propensity score matching was performed with propensity groups defined as those with low\u2013moderate postpartum pain and those with high postpartum pain. The relationships between pain measures and 6-month postpartum depression diagnosis by SCID, and between pain measures and 6-month postpartum depression symptoms by CESD, were assessed by unweighted logistic regression and by logistic regression weighted by propensity score derived by average treatment effect (ATE) adjusted for baseline covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 237 subjects in the cohort for analysis. Labor and postpartum pain were not associated with depression diagnosis by SCID at 6\u00a0months postpartum. However, postpartum pain, but not labor pain, was associated with depressive symptoms on the CESD at 6\u00a0months postpartum. Women with higher maximum postpartum pain scores had significantly higher odds of developing clinically significant postpartum depressive symptoms at 6\u00a0months, compared to those with lower pain scores in the unweighted model (OR: 1.3, 95% CI 1.0, 1.5;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) and ATE-weighted models (OR: 1.2, 95% CI 1.0, 1.5;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03). Consistent with prior work, SCID and CESD were strongly associated, and 92.9% (13\/14) of participants with postpartum depression diagnosis by 6-month SCID also showed high CESD symptomology,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although labor and postpartum pain were not associated with clinical diagnosis of depression (SCID) at 6\u00a0months postpartum, postpartum pain was linked to 6-month postpartum depression symptoms. Depressive symptoms are more likely to be exhibited in women with higher postpartum pain, potentially reflecting poorer birth recovery. The contribution of postpartum pain and depressive symptoms to overall patterns of poor recovery after childbirth should be assessed further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-022-06625-x","type":"journal-article","created":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T06:02:31Z","timestamp":1654322551000},"page":"1441-1449","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between labor and delivery pain and postpartum pain with symptoms and clinical diagnosis of postpartum depression in patients with overweight and obesity"],"prefix":"10.1007","volume":"307","author":[{"given":"Ezoza","family":"Rajabaliev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsea","family":"LaSorda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ibarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Kenkre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele D.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8013-0080","authenticated-orcid":false,"given":"Grace","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,4]]},"reference":[{"key":"6625_CR1","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1001\/jamapsychiatry.2013.87","volume":"70","author":"KL Wisner","year":"2013","unstructured":"Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, Eng HF, Luther JF, Wisniewski SR, Costantino ML, Confer AL, Moses-Kolko EL, Famy CS, Hanusa BH (2013) Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. 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