Department of Nursing, Technological Educational Institute of Crete, Greece.
Int J Nurs Stud. 2013 Jan;50(1):63-72. doi: 10.1016/j.ijnurstu.2012.08.012. Epub 2012 Sep 12.
Depression, and to a lesser extent postpartum depressive symptoms, have been associated with characteristics of the social environment and social capital. Up to the present, mostly cross-sectional studies have explored such an association without providing a clear temporal relationship between social capital and depression.
To estimate prospectively the effect of individual-level self-reported maternal social capital during pregnancy on postpartum depressive symptoms.
Prospective mother-child cohort (Rhea study).
4 prenatal clinics in Heraklion, Crete, Greece.
All women for one year beginning in February 2007. From the 1388 participants, complete data were available for 356 women.
Women self-completed two questionnaires: The Social Capital Questionnaire at about the 24th week of gestation and the Edinburgh Postnatal Depression Scale (range 0-30) at about the 8-10th week postpartum. Maternal social capital scores were categorized into three groups: the upper 10% was the high social capital group, the middle 80% was the medium and the lowest 10% was the low social capital group that served as the reference category. Multivariable log-binomial and linear regression models were performed for: the whole available sample; for participants with a history of depression and/or prenatal EPDS≥13; for participants without any previous or current depression and prenatal EPDS score<13. Potential confounders included demographic, socio-economic, lifestyle and pregnancy characteristics that have an established or potential association with maternal social capital in pregnancy or postpartum depressive symptoms or both.
Higher maternal social capital was associated with lower EPDS scores (highest vs lowest group: β-coefficient=-3.95, 95% CI -7.75, -0.14). Similar effects were noted for the subscale value of life/social agency (highest vs lowest group: β-coefficient=-5.96, 95% CI -9.52, -2.37). This association remained significant for women with and without past and/or present depression only for the subscale value of life/social agency although with a more imprecise estimate. No effect was found for participation, a structural dimension of social capital.
Women with higher individual-level social capital in mid-pregnancy reported less depressive symptoms 6-8 weeks postpartum. Given the proposed association of perceptions of the social environment with postpartum depressive symptoms, health professionals should consider evidence-based interventions to address depression in a social framework.
抑郁，以及在较小程度上的产后抑郁症状，与社会环境和社会资本的特征有关。迄今为止，大多数横断面研究都探讨了这种关联，但没有提供社会资本与抑郁之间的明确时间关系。
前瞻性估计孕妇自我报告的个体社会资本对产后抑郁症状的影响。
前瞻性母婴队列（Rhea 研究）。
希腊克里特岛伊拉克利翁的 4 个产前诊所。
从 2007 年 2 月开始的一年中的所有女性。在 1388 名参与者中，有 356 名女性完成了完整的数据。
女性自我完成了两份问卷：大约在妊娠 24 周时的社会资本问卷和大约在产后 8-10 周时的爱丁堡产后抑郁量表（范围 0-30）。将母亲的社会资本评分分为三组：上 10%为高社会资本组，中间 80%为中社会资本组，最低 10%为低社会资本组，作为参考组。对以下三种情况进行了多变量对数二项式和线性回归模型：全样本；有抑郁史和/或产前 EPDS≥13 的参与者；无任何既往或当前抑郁且产前 EPDS 评分<13 的参与者。潜在的混杂因素包括在妊娠或产后抑郁症状或两者中与母亲社会资本有既定或潜在关联的人口统计学、社会经济、生活方式和妊娠特征。
较高的母亲社会资本与较低的 EPDS 评分相关（最高组与最低组相比：β系数=-3.95，95%置信区间-7.75，-0.14）。生活/社会代理子量表的类似效果（最高组与最低组相比：β系数=-5.96，95%置信区间-9.52，-2.37）。对于有和没有过去和/或现在抑郁的女性，仅对子量表的生活/社会代理值，这种关联仍然显著，尽管估计不太准确。社会资本的结构维度参与度没有效果。
妊娠中期个体社会资本较高的女性报告产后 6-8 周时抑郁症状较少。鉴于社会环境的认知与产后抑郁症状之间的关联，卫生专业人员应考虑基于证据的干预措施，以在社会框架内解决抑郁问题。
