Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France; French School of Public Health (EHESP), Doctoral Network, Rennes, France.
Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France.
J Affect Disord. 2020 Jul 1;272:465-473. doi: 10.1016/j.jad.2020.04.024. Epub 2020 May 11.
An advantaged socioeconomic position (SEP) and satisfying social support during pregnancy (SSP) have been found to be protective factors of maternal postpartum depression (PDD). An advantaged SEP is also associated with satisfying SSP, making SSP a potential mediator of social inequalities in PPD. SEP, SSP and PPD are associated with migrant status. The aim of this study was to quantify the mediating role of SSP in social inequalities in PPD regarding mother's migrant status.
A sub-sample of 15,000 mothers from the French nationally-representative ELFE cohort study was used for the present analyses. SEP was constructed as a latent variable measured with educational attainment, occupational grade, employment, financial difficulties and household income. SSP was characterized as perceived support from partner (good relation, satisfying support and paternal leave) and actual support from midwives (psychosocial risk factors assessment and antenatal education). Mediation analyses with multiple mediators, stratified by migrant status were conducted.
Study population included 76% of non-migrant women, 12% of second and 12% of first generation migrant. SEP was positively associated with support from partner, regardless of migrant status. Satisfying partner support was associated with a 8 (non-migrant women) to 11% (first generation migrant women) reduction in PPD score.
History of depression was not reported.
Partner support could reduce social inequalities in PPD. This work supports the need of interventions, longitudinal and qualitative studies including fathers and adapted to women at risk of PPD to better understand the role of SSP in social inequalities in PPD.
在孕期中处于社会经济地位较高（SEP）和获得满意社会支持（SSP）的状态被发现是产妇产后抑郁（PDD）的保护因素。SEP 较高也与获得满意 SSP 相关，使 SSP 成为 PPD 中社会不平等的潜在中介因素。SEP、SSP 和 PPD 与移民身份有关。本研究旨在量化 SSP 在产妇移民身份方面 PPD 社会不平等中的中介作用。
本研究使用了法国全国代表性 ELFE 队列研究的一个 15000 名母亲的子样本进行分析。SEP 构建为一个潜变量，用教育程度、职业等级、就业状况、经济困难和家庭收入来衡量。SSP 特征为伴侣感知支持（良好关系、满意支持和父亲陪产假）和助产士实际支持（心理社会风险因素评估和产前教育）。对移民身份分层的多个中介变量进行了中介分析。
研究人群包括 76%的非移民女性、12%的第二代和 12%的第一代移民。SEP 与伴侣支持呈正相关，与移民身份无关。满意的伴侣支持与 PPD 评分降低 8%（非移民女性）至 11%（第一代移民女性）相关。
未报告抑郁病史。
伴侣支持可以减少 PPD 中的社会不平等。这项工作支持需要干预措施、纵向和定性研究，包括父亲，并针对有 PPD 风险的女性进行调整，以更好地理解 SSP 在 PPD 社会不平等中的作用。
