Sleep after delivery, according to parity among 2088 women.

<p>BIS - Bergen Insomnia Scale - sub scores represent number of days per week with the insomnia symptom.</p><p>h:mm - hours:minutes.</p

Differences in insomnia scores and other sleep parameters according to depressive status⁺ before and after delivery among 2088 women.

+<p>Depression was defined by EPDS (Edinburgh Postnatal Depression Scale) score ≥10.</p><p>BIS - Bergen insomnia Scale SD: Standard Deviation.</p><p>h:mm - hour: minutes.</p><p>**p<.001.</p><p>*p<.01.</p><p>a- difference from women with no depression before or after delivery.</p><p>b- difference from women with new onset depression postpartum.</p><p>c- difference from women who recovered from depression in pregnancy.</p

Sleep before and after delivery among 2088 women.

<p>BIS - Bergen Insomnia Scale - sub scores represent number of days per week with the insomnia symptom.</p><p>h:mm - hours:minutes.</p

Characteristics of the sample according to whether the participants opt to use epidural analgesia (EDA) during labour or not.

<p>Characteristics of the sample according to whether the participants opt to use epidural analgesia (EDA) during labour or not.</p

Flow chart displaying the recruitment and retention of the participants used in the present study.

<p>Flow chart displaying the recruitment and retention of the participants used in the present study.</p

Obstetric and psychological characteristics of women choosing epidural analgesia during labour: A cohort study

<div><p>Objectives</p><p>To investigate the obstetric and psychological characteristics of women who opt to use epidural analgesia (EDA) during labour and the impact of participating in labour preparation courses on women’s decisions to use EDA.</p><p>Design</p><p>Longitudinal cohort study.</p><p>Setting</p><p>Akershus University Hospital, Norway.</p><p>Population</p><p>2596 women with singleton pregnancies and intended vaginal delivery.</p><p>Methods</p><p>Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ). Symptoms of anxiety were measured by the Hopkins Symptom Check List (SCL-25) and depression by the Edinburgh Postnatal Depression Scale (EPDS). Obstetric and socio-demographic information was retrieved from birth records at the maternity ward.</p><p>Main outcome measure</p><p>Preference for EDA was indicated by the questionnaire item “I would prefer an epidural regardless” on a 4-point scale (1 = highly agree, 4 = highly disagree) at pregnancy week 32.</p><p>Results</p><p>Twenty-one percent of the women (540/2596) answered that they would choose EDA as the only alternative method of analgesia during labour. Counselling for fear of childbirth [OR 3.23 (95%CI 2.12; 4.92)] and W-DEQ sum score ≥ 85 [OR 2.95 (95%CI 2.06; 4.23)] were significantly (p<0.001) associated with choice of EDA. Participation in labour preparation courses was significantly (p = 0.008) associated with a reduction of intended use of EDA during labour [OR 0.67 (95%CI 0.49; 0.90)].</p><p>Conclusion</p><p>Fear of childbirth is significantly associated with women’s choice of EDA during labour. On the other hand, women that participate in labour preparation courses would rather consider other methods of analgesia during labour.</p></div

Risk factors for insomnia and for depressive symptoms eight weeks after delivery, results from a multivariate linear regression analysis among 1914 women.

a<p> R² = 0.209.</p>b<p> R² = 0.356.</p><p>*p values for Wilk's Lambda for the significance of the multivariate tests (the p values are common for insomnia and depression).</p><p>CI - Confidence Interval.</p><p>BIS - Bergen Insomnia Scale.</p><p>EPDS - Edinburgh Postnatal Depression Scale.</p><p>HSCL A - Hopkins Symptoms Checklist, Anxiety module.</p

Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) for preference for epidural analgesia (EDA).

<p>Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) for preference for epidural analgesia (EDA).</p

Adjusted^* associations between emotional distress (ED^†) and gestational length at birth (days).

<p>*adjusted for maternal age, educational level, smoking, pre-pregnancy body mass index, history of spontaneous abortion, late medical risk and neonate gender. For all analyses including ED at 30 weeks, the preterm group is limited to women delivering at 32+0–36+6 week's gestation.</p>†<p>emotional distress at 17 and 30 weeks are dichotomous variables, mean score ≥2 = 1.</p>‡<p>cases with covariates missing are excluded.</p>§<p>compared to no emotional distress at 30 weeks.</p

Background characteristics and distress measures according to preterm birth.

<p>*mean gestational age for filling out questionnaire 2 was 30 weeks, SD 2 weeks. However, some women filled out the form before 30 weeks' gestation while some gave birth after week 30 (in week 31). As a result, approximately 40% of those giving birth early preterm filled out questionnaire 2 and the SCL-5 a second time, even though they delivered early preterm.</p