A Longitudinal, Cohort Study Investigating the Impact of General Anaesthetic Caesarean Birth, With or Without ICU Admission, on Maternal Mental Health and Mother/Infant Bonding

NCT07115823 | Not Yet Recruiting

• 2 other identifiers: 359600RTF1201
• Study Type: observational
• Target: 500
• Locations: 1 country
• Sites: 1

Brief Summary

In the UK, approximately 6000 women every year undergo caesarean sections with general anaesthetic. Additionally, around 1300 women are admitted to Intensive Care Units (ICU) annually, typically due to pregnancy or childbirth complications. Some of these women are admitted to ICU for critical care immediately following a general anaesthetic caesarean section. However, there is little research on the impact of these experiences on women/birthing people and their families. This project aims to explore the impact of general anaesthetic caesarean section, with or without subsequent ICU admission, on a mother's mental health and bonding with her newborn. Women and birthing people who have undergone a caesarean section with an epidural or spinal anaesthesia can also take part in this study, so that outcomes can be compared for different types of caesarean birth.

Conditions

General Anaesthesia During Pregnancy

Keywords

General anaesthetic caesarean birth; Maternal mental health; Newborn bonding; Obstetric ICU admission

Outcome Measures

Primary Outcomes (2)

• Postnatal depression

  Depression scores (DASS-21)

  1-15 months post birth

• Newborn bonding

  PBQ scores

  1-15 months post birth

Secondary Outcomes (3)

• Anxiety

  1-15 months post birth

• PTSD symptoms

  1-15 months post birth.

• Self-harm

  1-15 months post birth

Study Arms (2)

Women or birthing people who have given birth by GACS

Women or birthing people aged 18 or older who have given birth by GACS in a UK hospital, within 12 months postpartum.

Women or birthing people who have given birth by NACS

Women or birthing people aged 18 or older who have given birth by NACS in a UK hospital, within 12 months postpartum.

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Any woman or birthing person who has undergone a caesarean section with general or neuraxial anaesthesia in a UK based hospital within 12 months postpartum.

You may qualify if:

• years of age and over
• Gave birth by caesarean section (CS) in a UK hospital within the last 12 months
• Able and willing to access the internet
• ICU admission following CS

You may not qualify if:

• Under 18 years of age.
• Vaginal birth (including instrumental) that did not lead to GACS or NACS
• CS that has not taken place in a UK hospital
• CS more than 12 months ago
• ICU admission immediately following CS outside of the UK.
• Unable to access the internet

Sponsors & Collaborators

• King's College London: lead
• Wellbeing of Women: collaborator
• Burdett Trust for Nursing: collaborator

Study Sites (1)

Faculty of Life Science and Medicine

London, SE1 7EH, United Kingdom

Location

Related Publications (35)

• Wittkowski A, Vatter S, Muhinyi A, Garrett C, Henderson M. Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility. Clin Psychol Rev. 2020 Dec;82:101906. doi: 10.1016/j.cpr.2020.101906. Epub 2020 Sep 3.

  PMID: 32977111 BACKGROUND

• Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002 Jul 18;347(3):194-9. doi: 10.1056/NEJMcp011542. No abstract available.

  PMID: 12124409 BACKGROUND

• Widstrom AM, Brimdyr K, Svensson K, Cadwell K, Nissen E. Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr. 2019 Jul;108(7):1192-1204. doi: 10.1111/apa.14754. Epub 2019 Mar 13.

  PMID: 30762247 BACKGROUND

• Reck C, Hunt A, Fuchs T, Weiss R, Noon A, Moehler E, Downing G, Tronick EZ, Mundt C. Interactive regulation of affect in postpartum depressed mothers and their infants: an overview. Psychopathology. 2004 Nov-Dec;37(6):272-80. doi: 10.1159/000081983. Epub 2004 Nov 9.

  PMID: 15539778 BACKGROUND

• Pownall M, Hutter RRC, Rockliffe L, Conner M. Memory and mood changes in pregnancy: a qualitative content analysis of women's first-hand accounts. J Reprod Infant Psychol. 2023 Nov;41(5):516-527. doi: 10.1080/02646838.2022.2052827. Epub 2022 Mar 20.

  PMID: 35306947 BACKGROUND

• Powell DN, Leonhardt ND. A Longitudinal Examination of Mothers' Early Postnatal Adaptation: Relative Stability Across the First Eight Weeks. Matern Child Health J. 2023 Dec;27(12):2175-2184. doi: 10.1007/s10995-023-03776-4. Epub 2023 Sep 28.

  PMID: 37768532 BACKGROUND

• NMPA Project Team. National maternity and perinatal audit: clinical report (2019) Based on births in NHS maternity services between 1st April 2016 and 31st March 2017. Royal College of Obstetrics and Gynaecology, London 2019. NMPA Clinical Report 2019.pdf (maternityaudit.org.uk)

  BACKGROUND

• NMPA Project Team. National maternity and perinatal audit: clinical report (2021) Based on births in NHS maternity services between 1st April 2017 and 31st March 2018. Royal College of Obstetrics and Gynaecology, London 2019. NMPA Clinical Report 2019.pdf (maternityaudit.org.uk).

  BACKGROUND

• Nakic Rados S, Matijas M, Kuhar L, Andelinovic M, Ayers S. Measuring and conceptualizing PTSD following childbirth: Validation of the City Birth Trauma Scale. Psychol Trauma. 2020 Feb;12(2):147-155. doi: 10.1037/tra0000501. Epub 2019 Aug 1.

  PMID: 31368743 BACKGROUND

• National Maternity and Perinatal Audit Clinical Report 2022 Based on births in NHS maternity services in England and Wales between 1 April 2018 and 31 March 2019 Ref 336 NMPA Clinical Report_2022.pdf (maternityaudit.org.uk).

  BACKGROUND

• Neczypor JL, Holley SL. Providing Evidence-Based Care During the Golden Hour. Nurs Womens Health. 2017 Dec;21(6):462-472. doi: 10.1016/j.nwh.2017.10.011.

  PMID: 29223210 BACKGROUND

• Mehra R, Shebl FM, Cunningham SD, Magriples U, Barrette E, Herrera C, Kozhimannil KB, Ickovics JR. Area-level deprivation and preterm birth: results from a national, commercially-insured population. BMC Public Health. 2019 Feb 27;19(1):236. doi: 10.1186/s12889-019-6533-7.

  PMID: 30813938 BACKGROUND

• Lovibond SH, Lovibond PF: Manual for the Depression Anxiety Stress Scales . 1995, Sydney , Psychology Foundation of Australia, 2nd.

  BACKGROUND

• Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995 Mar;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u.

  PMID: 7726811 BACKGROUND

• Krawczyk P, Jastrzebska A, Lipka D, Huras H. Pregnancy related and postpartum admissions to intensive care unit in the obstetric tertiary care center - an 8-year retrospective study. Ginekol Pol. 2021;92(8):575-578. doi: 10.5603/GP.a2021.0034. Epub 2021 Apr 12.

  PMID: 33844261 BACKGROUND

• Knight M, B. K., Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk. (2022). Saving Lives, Improving Mother's Care Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Morbidity 2018-2020. Retrieved from https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2022/MBRRACE-UK_Maternal_MAIN_Report_2022_v10.pdf

  BACKGROUND

• Handelzalts JE, Hairston IS, Matatyahu A. Construct Validity and Psychometric Properties of the Hebrew Version of the City Birth Trauma Scale. Front Psychol. 2018 Sep 18;9:1726. doi: 10.3389/fpsyg.2018.01726. eCollection 2018.

  PMID: 30279671 BACKGROUND

• Grunberg VA, Geller PA, Hoffman C, Njoroge W, Ahmed A, Patterson CA. Parental mental health screening in the NICU: a psychosocial team initiative. J Perinatol. 2022 Mar;42(3):401-409. doi: 10.1038/s41372-021-01217-0. Epub 2021 Sep 27.

  PMID: 34580422 BACKGROUND

• Ferguson S, Browne J, Taylor J, Davis D. Sense of coherence and women׳s birthing outcomes: A longitudinal survey. Midwifery. 2016 Mar;34:158-165. doi: 10.1016/j.midw.2015.11.017. Epub 2015 Dec 2.

  PMID: 26689770 BACKGROUND

• Faulks F, Edvardsson K, Mogren I, Gray R, Copnell B, Shafiei T. Common mental disorders and perinatal outcomes in Victoria, Australia: A population-based retrospective cohort study. Women Birth. 2024 Mar;37(2):428-435. doi: 10.1016/j.wombi.2024.01.001. Epub 2024 Jan 12.

  PMID: 38216393 BACKGROUND

• Farr SL, Dietz PM, O'Hara MW, Burley K, Ko JY. Postpartum anxiety and comorbid depression in a population-based sample of women. J Womens Health (Larchmt). 2014 Feb;23(2):120-8. doi: 10.1089/jwh.2013.4438. Epub 2013 Oct 26.

  PMID: 24160774 BACKGROUND

• Edwards DR, Porter SA, Stein GS. A pilot study of postnatal depression following caesarean section using two retrospective self-rating instruments. J Psychosom Res. 1994 Feb;38(2):111-7. doi: 10.1016/0022-3999(94)90084-1.

  PMID: 8189400 BACKGROUND

• De Schepper S, Vercauteren T, Tersago J, Jacquemyn Y, Raes F, Franck E. Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study. Midwifery. 2016 Jan;32:87-92. doi: 10.1016/j.midw.2015.08.010. Epub 2015 Sep 8.

  PMID: 26410818 BACKGROUND

• Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150:782-6. doi: 10.1192/bjp.150.6.782.

  PMID: 3651732 BACKGROUND

• Chantry AA, Monnet C, Fresson J, Miller D, Bonnet MP, Deneux-Tharaux C. Repeated maternal ICU admission: Results from a nationwide analysis. Anaesth Crit Care Pain Med. 2021 Oct;40(5):100905. doi: 10.1016/j.accpm.2021.100905. Epub 2021 Jun 18.

  PMID: 34153532 BACKGROUND

• Caparros-Gonzalez RA, Romero-Gonzalez B, Peralta-Ramirez MI, Ayers S, Galan-Paredes A, Caracuel-Romero A. Assessment of posttraumatic stress disorder among women after childbirth using the City Birth Trauma Scale in Spain. Psychol Trauma. 2021 Jul;13(5):545-554. doi: 10.1037/tra0001007. Epub 2021 Jan 28.

  PMID: 33507792 BACKGROUND

• Brockington IF, Fraser C, Wilson D. The Postpartum Bonding Questionnaire: a validation. Arch Womens Ment Health. 2006 Sep;9(5):233-42. doi: 10.1007/s00737-006-0132-1. Epub 2006 May 4.

  PMID: 16673041 BACKGROUND

• Brockington I. Postpartum psychiatric disorders. Lancet. 2004 Jan 24;363(9405):303-10. doi: 10.1016/S0140-6736(03)15390-1.

  PMID: 14751705 BACKGROUND

• Roxanne B, Laura VDB, Yannic VG, Natacha VC, Luka VL, Kuipers YJ. Validation of the postpartum bonding questionnaire: A cross-sectional study among Flemish mothers. Midwifery. 2022 Apr;107:103280. doi: 10.1016/j.midw.2022.103280. Epub 2022 Feb 8.

  PMID: 35182820 BACKGROUND

• Bhatia K, Columb M, Bewlay A, Eccles J, Hulgur M, Jayan N, Lie J, Verma D, Parikh R. The effect of COVID-19 on general anaesthesia rates for caesarean section. A cross-sectional analysis of six hospitals in the north-west of England. Anaesthesia. 2021 Mar;76(3):312-319. doi: 10.1111/anae.15313. Epub 2020 Nov 2.

  PMID: 33073371 BACKGROUND

• Bell AF, Andersson E. The birth experience and women's postnatal depression: A systematic review. Midwifery. 2016 Aug;39:112-23. doi: 10.1016/j.midw.2016.04.014. Epub 2016 May 7.

  PMID: 27321728 BACKGROUND

• Bamber JH, Lucas DN, Plaat F, Russell R. Obstetric anaesthetic practice in the UK: a descriptive analysis of the National Obstetric Anaesthetic Database 2009-14. Br J Anaesth. 2020 Oct;125(4):580-587. doi: 10.1016/j.bja.2020.06.053. Epub 2020 Jul 28.

  PMID: 32736825 BACKGROUND

• Bamber JH, Goldacre R, Lucas DN, Quasim S, Knight M. A national cohort study to investigate the association between ethnicity and the provision of care in obstetric anaesthesia in England between 2011 and 2021. Anaesthesia. 2023 Jul;78(7):820-829. doi: 10.1111/anae.15987. Epub 2023 Mar 9.

  PMID: 36893444 BACKGROUND

• Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand. 2012 Nov;91(11):1261-72. doi: 10.1111/j.1600-0412.2012.01476.x. Epub 2012 Aug 13.

  PMID: 22670573 BACKGROUND

• Ayers S, Wright DB, Thornton A. Development of a Measure of Postpartum PTSD: The City Birth Trauma Scale. Front Psychiatry. 2018 Sep 18;9:409. doi: 10.3389/fpsyt.2018.00409. eCollection 2018.

  PMID: 30279664 BACKGROUND

Related Links

• NIHR South London Applied Research Collaboration

Study Officials

• Dr Hannah Rayment-Jones

  King's College London

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Michelle Anderson, PhD Candidate

CONTACT

+447957955462; michelle.4.anderson@kcl.ac.uk

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 4, 2025
• First Posted: August 11, 2025
• Study Start: November 1, 2025
• Primary Completion: March 31, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: August 11, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)