Bilszta Justin L C, Tang Melissa, Meyer Denny, Milgrom Jeannette, Ericksen Jennifer, Buist Anne E
Department of Psychiatry, University of Melbourne, Vic., Australia.
Aust N Z J Psychiatry. 2008 Jan;42(1):56-65. doi: 10.1080/00048670701732731.
In the transition to parenthood, lack of social support significantly impacts on maternal mood. This paper compares the influence of single-mother status and level of partner support in a partnered relationship, on antenatal emotional health.
Antenatal demographic, psychosocial and mental health data, as determined by Edinburgh Postnatal Depression Scale (EPDS) score, were collected from 1578 women. The association between these variables, and marital status, was investigated using logistic regression.
Sixty-two women (3.9%) were identified as single/unpartnered. Elevated EPDS scores (>12) were found in 15.2% (240/1578) of the total cohort and 25.8% (16/62) of the single/unpartnered women. EPDS scores were significantly lower for single/unpartnered women than for women with unsupportive partners (8.9+/-5.3 vs 11.9+/-6.5, p<0.001). Compared to the partnered cohort, single/unpartnered women were more likely to have experienced >or=2 weeks of depression before the current pregnancy (p<0.05), a previous psychopathology (p<0.001), emotional problems during the current pregnancy (p<0.01) and major life events in the last year (p<0.01). Binary logistic regression modelling to predict antenatal EPDS scores suggests that this is mediated by previous psychiatric history (p<0.001) and emotional problems during pregnancy (p=0.02).
Women in a partnered-relationship with poor partner-derived support were at an increased risk of elevated antenatal EPDS scores compared to single/unpartnered women. A previous history of depression and current emotional problems, rather than single mother status, were significant risk factors for elevated EPDS scores. The present study reiterates the contribution of psychosocial risk factors as important mediators of antenatal emotional health.
在向为人父母的转变过程中,缺乏社会支持会对产妇情绪产生重大影响。本文比较了单亲母亲身份以及伴侣关系中伴侣支持程度对产前情绪健康的影响。
采用爱丁堡产后抑郁量表(EPDS)评分,收集了1578名女性的产前人口统计学、心理社会和心理健康数据。使用逻辑回归分析这些变量与婚姻状况之间的关联。
62名女性(3.9%)被确定为单身/无伴侣。在整个队列中,15.2%(240/1578)的女性EPDS评分升高(>12),在单身/无伴侣女性中这一比例为25.8%(16/62)。单身/无伴侣女性的EPDS评分显著低于伴侣支持不足的女性(8.9±5.3 vs 11.9±6.5,p<0.001)。与有伴侣的队列相比,单身/无伴侣女性在本次怀孕前更有可能经历过≥2周的抑郁(p<0.05)、既往精神病理学问题(p<0.001)、本次怀孕期间的情绪问题(p<0.01)以及过去一年中的重大生活事件(p<0.01)。用于预测产前EPDS评分的二元逻辑回归模型表明,这是由既往精神病史(p<0.001)和怀孕期间的情绪问题(p=0.02)介导的。
与单身/无伴侣女性相比,伴侣支持不足的有伴侣关系女性产前EPDS评分升高的风险增加。既往抑郁史和当前情绪问题而非单亲母亲身份是EPDS评分升高的重要危险因素。本研究重申了心理社会风险因素作为产前情绪健康重要调节因素的作用。