School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
BMC Pregnancy Childbirth. 2022 Mar 8;22(1):193. doi: 10.1186/s12884-022-04522-4.
Prevalence of perinatal depression is high in Rwanda and has been found to be associated with the quality of relationship with partner. This study extends this work to examine the relationship between antenatal depressive symptoms and social support across several relationships among women attending antenatal care services.
Structured survey interviews were conducted with 396 women attending antenatal care services in 4 health centres in the Southern Province of Rwanda. The Edinburgh Postnatal Depression Scale (EPDS) and Maternity Social Support Scale (MSSS) were used to assess antenatal depressive symptoms and the level of support respectively. Socio-demographic and gestational information, pregnancy intentions, perceived general health status, and experience of violence were also collected. Univariate, bivariate analyses and a multivariate logistic regression model were performed to determine the relationship between social support and risk factors for antenatal depressive symptoms.
More than half of respondents were married (55.1%) or living with a partner in a common-law relationship (28.5%). About a third (35.9%) were in their 6th month of pregnancy; the rest were in their third term. The prevalence of antenatal depressive symptoms was 26.6% (EPDS ≥ 12). Bivariate analyses suggested that partner and friend support negatively predict depression level symptoms. Adjusting for confounding variables such as unwanted pregnancy (AOR: 0.415, CI: 0.221- 0.778), parity (AOR: 0.336, CI: 0.113-1.000) and exposure to extremely stressful life events (AOR: 2.300, CI: 1.263- 4.189), partner support (AOR: 4.458, CI: 1.833- 10.842) was strongly significantly associated with antenatal depressive symptoms; women reporting good support were less likely to report depressive symptoms than those reporting poor support or those with no partner. Friend support was no longer significant.
The study revealed that social support may be a strong protector against antenatal depressive symptoms but only support from the partner. This suggests that strengthening support to pregnant women may be a successful strategy for reducing the incidence or severity of maternal mental health problems, but more work is required to assess whether support from the broader social network can compensate for absent or unsupportive partners.
卢旺达围产期抑郁症的患病率很高，并且已发现与伴侣关系质量有关。本研究扩展了这项工作，以检查在接受产前保健服务的女性中，几种关系中产前抑郁症状与社会支持之间的关系。
在卢旺达南部 4 个卫生中心的 396 名接受产前保健服务的妇女中进行了结构化的调查访谈。使用爱丁堡产后抑郁量表（EPDS）和产妇社会支持量表（MSSS）分别评估产前抑郁症状和支持水平。还收集了社会人口统计学和妊娠信息、妊娠意图、感知一般健康状况和暴力经历。进行了单变量、双变量分析和多变量逻辑回归模型，以确定社会支持与产前抑郁症状的危险因素之间的关系。
超过一半的受访者已婚（55.1%）或与伴侣处于事实婚姻关系（28.5%）。约三分之一（35.9%）处于第六个月的妊娠；其余的都在第三个三个月。产前抑郁症状的患病率为 26.6%（EPDS≥12）。双变量分析表明，伴侣和朋友的支持可降低抑郁症状的水平。调整了意外怀孕（AOR：0.415，CI：0.221-0.778）、产次（AOR：0.336，CI：0.113-1.000）和经历极度压力的生活事件（AOR：2.300，CI：1.263-4.189）等混杂变量后，伴侣支持（AOR：4.458，CI：1.833-10.842）与产前抑郁症状呈强烈显著相关；报告支持良好的女性比报告支持不佳或没有伴侣的女性更不可能报告抑郁症状。朋友的支持不再显著。
研究表明，社会支持可能是预防产前抑郁症状的有力保护因素，但只有来自伴侣的支持才是如此。这表明，加强对孕妇的支持可能是降低产妇心理健康问题发生率或严重程度的成功策略，但需要做更多的工作来评估更广泛的社会网络支持是否可以弥补缺失或不支持的伴侣。
