Li Yingtao, Zeng Yingchun, Zhu Wei, Cui Ying, Li Jie
Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Nursing, Shandong Medical College, Jinan, China.
BMC Pregnancy Childbirth. 2016 Jul 21;16(1):180. doi: 10.1186/s12884-016-0972-2.
Antenatal maternal mental health problems have numerous consequences for the well-being of both mother and child. This study aimed to test and construct a pertinent model of antenatal depressive symptoms within the conceptual framework of a stress process model.
This study utilized a cross-sectional study design.
participants were adult women (18 years or older) having a healthy pregnancy, in their third trimester (the mean weeks gestation was 34.71).
depressive and anxiety symptoms were measured by Zung's Self-rating Depressive and Anxiety Scale, stress was measured by Pregnancy-related Pressure Scale, social support and coping strategies were measured by Social Support Rating Scale and Simplified Coping Style Questionnaire, respectively.
path analysis was applied to examine the hypothesized causal paths between study variables.
A total of 292 subjects were enrolled. The final testing model showed good fit, with normed χ (2) = 32.317, p = 0.061, CFI = 0.961, TLI = 0.917, IFI = 0.964, NFI = 0.900, RMSEA = 0.042. This path model supported the proposed model within the theoretical framework of the stress process model. Pregnancy-related stress, financial strain and active coping have both direct and indirect effects on depressive symptoms. Psychological preparedness for delivery, social support and anxiety levels have direct effects on antenatal depressive symptoms. Good preparedness for delivery could reduce depressive symptoms, while higher levels of anxiety could significantly increase depressive symptoms. Additionally, there were indirect effects of miscarriage history, irregular menstruation, partner relationship and passive coping with depressive symptoms.
The empirical support from this study has enriched theories on the determinants of depressive symptoms among Chinese primipara, and could facilitate the formulation of appropriate interventions for reducing antenatal depressive symptoms, and enhancing the mental health of pregnant women.
产前母亲心理健康问题对母亲和孩子的幸福都会产生诸多影响。本研究旨在应激过程模型的概念框架内检验并构建一个有关产前抑郁症状的相关模型。
本研究采用横断面研究设计。
参与者为成年女性（18岁及以上），孕期健康，处于孕晚期（平均孕周为34.71周）。
抑郁和焦虑症状通过zung氏自评抑郁量表和焦虑量表进行测量，应激通过妊娠相关压力量表进行测量，社会支持和应对策略分别通过社会支持评定量表和简易应对方式问卷进行测量。
应用路径分析来检验研究变量之间的假设因果路径。
共纳入292名受试者。最终检验模型显示拟合良好，标准化χ(2)=32.317，p = 0.061，CFI = 0.961，TLI = 0.917，IFI = 0.964，NFI = 0.900，RMSEA = 0.042。该路径模型在应激过程模型的理论框架内支持了所提出的模型。妊娠相关应激、经济压力和积极应对方式对抑郁症状均有直接和间接影响。分娩心理准备、社会支持和焦虑水平对产前抑郁症状有直接影响。良好的分娩准备可减轻抑郁症状，而较高的焦虑水平则会显著增加抑郁症状。此外，流产史、月经不规律、伴侣关系和消极应对方式对抑郁症状有间接影响。
本研究的实证支持丰富了关于中国初产妇抑郁症状决定因素的理论，并有助于制定适当的干预措施以减少产前抑郁症状，提高孕妇的心理健康水平。
