Prognostic factors of depression and anxiety in infertile women with cesarean scar defects

doi:10.5498/wjp.121996

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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

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. Oct 19, 2026; 16(10): 121996
Published online Oct 19, 2026. doi: 10.5498/wjp.121996

Prognostic factors of depression and anxiety in infertile women with cesarean scar defects

Xiao-Bin Lin, Li-Li Luo, Ying-Xing Chen, Yu-Ping Li, Hui-Min You, Xiao-Fen Chen, Qiu-Ping Wei, Qiao-Yu Zhang, Xiao-Lan Huang

Xiao-Bin Lin, Yu-Ping Li, Qiao-Yu Zhang, Xiao-Lan Huang, Department of Gynecology, Army 73^rd Group Military Hospital, Xiamen 361000, Fujian Province, China

Li-Li Luo, Department of Obstetrics, Army 73^rd Group Military Hospital, Xiamen 361000, Fujian Province, China

Ying-Xing Chen, Department of Rehabilitation Medicine, Army 73^rd Group Military Hospital, Xiamen 361000, Fujian Province, China

Hui-Min You, Qiu-Ping Wei, Department of Nursing, Army 73^rd Group Military Hospital, Xiamen 361000, Fujian Province, China

Xiao-Fen Chen, Department of Psychiatry, Army 73^rd Group Military Hospital, Xiamen 361000, Fujian Province, China

Co-first authors: Xiao-Bin Lin and Li-Li Luo.

Co-corresponding authors: Qiao-Yu Zhang and Xiao-Lan Huang.

Author contributions: Lin XB and Luo LL contributed equally to this work as co-first authors, and they were responsible for study conception, data collection, and manuscript drafting; Chen YX contributed to clinical assessment and data interpretation; Li YP, You HM, and Wei QP participated in patient follow-up and data organization; Chen XF conducted psychiatric and psychological evaluations; Zhang QY and Huang XL, as co-corresponding authors, supervised the study design, revised the manuscript, and gave final approval. Both meet all four ICMJE authorship criteria, and their dual designation reflects their equal and complementary supervisory contributions to this work. All authors approved the final version of this manuscript.

AI contribution statement: The AI tool Kimi 2.6 (Moonshot AI) was used solely for language polishing and improving the sentence structure and expression of this manuscript. It was not used in any aspect of study design, data collection, data analysis, interpretation of results, or generation of scientific content.

Institutional review board statement: This study was reviewed and approved by the Institutional Ethics Committee of Army 73rd Group Military Hospital (approval No. 73JYY2026215137).

Informed consent statement: Individual informed consent was waived in accordance with national guidelines applicable to retrospective, anonymized studies.

Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.

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 generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Xiao-Lan Huang, Department of Gynecology, Army 73^rd Group Military Hospital, No. 92-96 Wenyuan Road, Siming District, Xiamen 361000, Fujian Province, China. huangxiaolana@163.com

Received: May 15, 2026
Revised: June 15, 2026
Accepted: August 10, 2026
Published online: October 19, 2026
Processing time: 148 Days and 0.9 Hours

Core Tip

Core Tip: This retrospective cohort study is the first to systematically characterize the psychological burden of cesarean scar defect (CSD)-associated infertility and quantify its independent prognostic contribution to assisted reproductive technology (ART) outcomes. Among the 100 women included, clinically significant anxiety and depression were detected in 74% and 68%, respectively—rates that nearly double those reported in general infertile populations. Multivariate logistic regression identified six independent prognostic factors for ART failure: Anxiety score, fertility-related quality of life, residual myometrial thickness, CSD severity, co-morbid anxiety and depression, and spousal support. These findings support routine psychological screening and CSD-severity-based risk stratification as essential components of ART management.