Effect of labor-delivery-recovery-postpartum family-centered obstetrics care combined with painless delivery on postpartum depression in primiparas

doi:10.5498/wjp.v16.i8.116923

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 116923
Published online Aug 19, 2026. doi: 10.5498/wjp.v16.i8.116923

Effect of labor-delivery-recovery-postpartum family-centered obstetrics care combined with painless delivery on postpartum depression in primiparas

Xiao-Rong Gong, Xu-Miao Song, Xue-Chai Bao

Xiao-Rong Gong, Xu-Miao Song, Xue-Chai Bao, Department of Obstetrics, North Branch, Ningbo University Affiliated Women and Children’s Hospital, Ningbo 315031, Zhejiang Province, China

Author contributions: Gong XR wrote the main manuscript; Song XM collected the data; Bao XC analysed, interpreted, and reviewed the results; all authors prepared the table and figures; all authors approved the final version of the manuscript prior to submission.

AI contribution statement: We confirm that AI-based tools, including Grammarly and DeepL, were used solely for language polishing and grammatical improvement of the manuscript. All scientific content, data analysis, interpretation, and conclusions were entirely developed and verified by the authors, and no AI tool was used for study design or figure generation.

Supported by Ningbo Public Welfare Research Project, No. 2024S147.

Institutional review board statement: This study was approved by the Ethics Committee of Ningbo University Affiliated Women and Children’s Hospital, Approval No. NBFE-2026-KY-023. All methods were carried out in accordance with the Declaration of Helsinki.

Informed consent statement: For this retrospective study utilizing existing clinical data, the Ethics Committee waived the need for additional informed consent while confirming compliance with relevant data protection regulations.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest regarding this work.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: The datasets used and analysed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Xiao-Rong Gong, Department of Obstetrics, North Branch, Ningbo University Affiliated Women and Children’s Hospital, No. 266 Cishui West Street, Cicheng New Town, Jiangbei District, Ningbo 315031, Zhejiang Province, China. gxrrr1516@163.com

Received: November 25, 2025
Revised: January 26, 2026
Accepted: March 19, 2026
Published online: August 19, 2026
Processing time: 240 Days and 8.8 Hours

Abstract

BACKGROUND

Postpartum depression (PPD) is a prevalent perinatal mood disorder, marked by persistent low mood, anhedonia, and impaired maternal-infant bonding within six weeks postpartum. PPD impairs maternal quality of life, leads to long-term harms, and poses a notable public health burden.

AIM

To investigate the effect of labor-delivery-recovery-postpartum (LDRP) family-centered obstetrics care combined with painless delivery on PPD in primiparas.

METHODS

This retrospective cohort study enrolled 523 primiparas (singleton, term, cephalic, spontaneous labor) from January 2023 to April 2025. The participants were divided into a control group (n = 266, conventional care) and an observation group (n = 257, LDRP + painless delivery). Labor progression, comfort [General Comfort Questionnaire (GCQ) and pain Visual Analog Scale (VAS)], mental health [Childbirth Attitude Questionnaire (CAQ), Pregnancy-Related Anxiety Scale (PAQ), and Edinburgh Postnatal Depression Scale (EPDS)], maternal-neonatal outcomes, and nursing satisfaction were compared between the two groups. Logistic regression was used to identify the risk factors for PPD.

RESULTS

Baseline characteristics were comparable between the two groups (all P > 0.05). The observation group exhibited shorter first/second stages of labor (P < 0.001), higher GCQ scores (all dimensions, P < 0.001), lower VAS scores (P < 0.001), and lower CAQ, PAQ, and EPDS scores (P < 0.001). The incidence of PPD (16.34% vs 33.46%) and severe PPD (4.67% vs 13.91%) were significantly lower in the observation group (P < 0.001). No significant differences were observed in maternal-neonatal safety outcomes (P > 0.05). Nursing satisfaction was higher in the observation group (95.72% vs 70.30%, P < 0.001). Logistic regression analysis identified gestational complications, lack of family accompaniment, nursing dissatisfaction, absence of painless delivery, and no-use of LDRP as independent risk factors for PPD (P < 0.05).

CONCLUSION

LDRP family-centered care combined with painless delivery reduces PPD by shortening labor and improving comfort and nursing satisfaction, supporting its clinical adoption. Clinically, this integrated care model may help improve the childbirth experience and reduce the risk of PPD in primiparas. Future multicenter prospective studies with longer follow-up are needed to further validate these findings and assess their long-term impact on maternal mental health.

Keywords: Labor-delivery-recovery-postpartum family-centered obstetrics care; Painless delivery; Primiparas; Postpartum depression; Labor outcome

Core Tip: This study explores the impact of the labor-delivery-recovery-postpartum (LDRP) family-centered obstetrics care combined with painless delivery on postpartum depression (PPD) in primiparas. The results indicate that the observation group (LDRP + painless delivery) experienced significantly shorter labor, higher comfort levels, and lower rates of PPD compared to the conventional care group. Additionally, gestational complications, lack of family support, and nursing dissatisfaction were identified as independent risk factors for PPD. These findings suggest that LDRP family-centered care and painless delivery can significantly reduce PPD while ensuring maternal and neonatal safety.