Department of Midwifery, TEI of Athens, Athens, Greece,
Arch Womens Ment Health. 2013 Oct;16(5):353-61. doi: 10.1007/s00737-013-0338-y. Epub 2013 Apr 5.
A range of psychosocial, medical, and demographic variables may influence pregnant women's psychological status. However the association between coping strategies, anxiety, worries, and depression during pregnancy is a relatively neglected area of research. Therefore, the aim of this study was to examine the relationship between coping strategies, antenatal anxiety, pregnancy worries, and depressive symptomatology after controlling for the effects of background variables. The study sample consisted of 163 pregnant women, with gestational age ranging from 11 to 26 weeks, attending antenatal screening at a Greek public hospital. Coping strategies were measured with Brief COPE, pregnancy worries were measured with Cambridge Worry Scale (CWS), anxiety was assessed using State-Trait Anxiety Inventory (STAI-X version), and depression was measured with Center for Epidemiologic Studies-Depression scale (CES-D). Pearson's correlation coefficients were calculated among all study variables, followed by hierarchical multiple linear regression. In the univariate analysis, low annual income, unemployment, conception after an IVF treatment, and a previous history of miscarriage were associated with anxiety, depression, and worries. Additionally, almost all coping strategies (denial, behavioral disengagement, self-blame, self-distraction, substance use, acceptance, positive reframing, active coping, and seeking emotional support) were significantly associated with antenatal anxiety, worries, and depression. Linear regression analysis showed that only previous history of miscarriage, conception after IVF, as well as denial, behavioral disengagement and acceptance coping strategies were significantly related to anxiety, worries and depressive symptomatology. The risk factors found in this study could help clinicians target anxiety and depression screening to high-risk populations of pregnant women. Provision of adequate training for obstetricians and midwives in the detection and management of anxiety and depression among pregnant women should help to decrease the psychological burden during pregnancy.
一系列心理社会、医学和人口统计学变量可能会影响孕妇的心理状态。然而,应对策略、妊娠期间的焦虑、担忧和抑郁之间的关系是一个相对被忽视的研究领域。因此,本研究旨在检验应对策略、产前焦虑、妊娠担忧与抑郁症状之间的关系,同时控制背景变量的影响。研究样本由 163 名孕妇组成,孕周为 11 至 26 周,在希腊一家公立医院接受产前筛查。采用Brief COPE 量表评估应对策略,采用剑桥担忧量表(CWS)评估妊娠担忧,采用状态-特质焦虑量表(STAI-X 版本)评估焦虑,采用流行病学研究中心抑郁量表(CES-D)评估抑郁。对所有研究变量进行 Pearson 相关系数分析,随后进行分层多元线性回归。在单变量分析中,低收入、失业、体外受精(IVF)治疗后受孕和流产史与焦虑、抑郁和担忧有关。此外,几乎所有的应对策略(否认、行为脱离、自责、自我分心、物质使用、接受、积极重新构建、积极应对和寻求情感支持)与产前焦虑、担忧和抑郁显著相关。线性回归分析显示,只有流产史、IVF 受孕以及否认、行为脱离和接受应对策略与焦虑、担忧和抑郁症状显著相关。本研究发现的风险因素有助于临床医生将焦虑和抑郁筛查目标对准高危孕妇人群。为产科医生和助产士提供充分的培训,以提高他们对孕妇焦虑和抑郁的识别和管理能力,有助于减轻妊娠期间的心理负担。