{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:28:34Z","timestamp":1787869714366,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine risks of caesarean section (CS) and instrumental deliveries, including CS on individual request, in birthing people with mental disorders, overall and according to indications (i.e., Robson group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Register\u2010based total population study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Record\u2010linkage of administrative and health data registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>A total of 178,069 people with a delivery during 2014\u20132020 in Stockholm County.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mental disorders in birthing people were identified from health care registers as at least one recorded diagnosis according to ICD\u201010, and categorised as non\u2010psychotic mood and anxiety disorders, severe, psychotic neurodevelopmental, and other mental disorders. Binary and multinomial regression analyses were used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI), overall and stratified by Robson group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Overall mode of delivery (non\u2010instrumental vaginal, instrumental vaginal, elective and emergency CS) and CS on individual request (yes\/no).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 143\u2009483 individuals were included in the analysis. Among them, 10.06% had elective caesarean section (CS), 10.89% non\u2010elective CS, 5.61% instrumental delivery, and 5.70% CS on maternal request. The adjusted odds ratio of elective CS (aOR 1.54, 95% CI 1.49\u20131.60), emergency CS (aOR 1.24, 95% CI 1.20\u20131.28), and CS on request (aOR 2.05, 95% CI 1.96\u20132.14) was increased among birthing people with mental disorders. The associations were of similar magnitudes regardless of the type of mental disorder, but particularly pronounced among nulliparous birthing people with full\u2010term, single, cephalic delivery (Robson group 1\u20132).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mental disorders in birthing people are associated with an increased risk of caesarean section, both overall and on birthing person request. There may be unmet needs for obstetric care in birthing people with mental disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70032","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:41:02Z","timestamp":1759308062000},"page":"422-431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mode of Delivery and Request for Caesarean Section in Birthing People With Mental Disorders: A Register\u2010Based Total Population Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3261-3429","authenticated-orcid":false,"given":"Olga","family":"Kazakova","sequence":"first","affiliation":[{"name":"Centre for Epidemiology and Community Medicine Region Stockholm  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriaki","family":"Kosidou","sequence":"additional","affiliation":[{"name":"Centre for 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Community Medicine Region Stockholm  Stockholm Sweden"},{"name":"Department of Global Public Health Karolinska Institutet  Stockholm 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