Objective:The aim of this study was to investigate the associations between psychological factors(depression,anxiety, and stress)during pregnancy and non-indicated cesarean delivery. Methods:We conducted a prospective cohort study of 1 453 women who were enrolled between October 2016 and January 2019 in the Women’s Hospital of Nanjing Medical University. The self-rating anxiety scale,Centre for Epidemiologic Studies Depression scale,and perceived stress scale were used to assess the psychological status of pregnant women in the first,second and third trimesters. The generalized estimation equation(GEE)was performed to investigate the association between antepartum psychological status and cesarean delivery among pregnant women without medical indications for cesarean delivery. Results:Among the 1 453 participants in this study,516 had medical indications for cesarean delivery. The rest 937 women had no medical indications for cesarean delivery,among which 139 women had cesarean delivery. Any adverse psychological symptom(depression,anxiety,or stress)in late pregnancy was associated with increased risk of non -indicated cesarean delivery(OR=1.69,95%CI:1.04~2.73,P=0.034)after the adjustment for maternal age at delivery,pre-pregnancy body mass index(BMI),diabetes during pregnancy,parity,and gestational age. Particularly,depressive symptom in pregnant women was significantly related to the risk of non-indicated cesarean delivery(OR=1.32,95%CI:1.03~1.69,P=0.028). No statistically significant association was observed between stress and press in women and the risk of non-indicated cesarean delivery. Conclusion:Depressive symptom in the third trimester increased the risk of non-indicated cesarean delivery. It is suggested that more attention should be paid to the psychological counseling of pregnant women,especially in late pregnancy.