Evidence-Based Nursing Centre, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
West China School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China.
BMC Pregnancy Childbirth. 2022 Mar 8;22(1):188. doi: 10.1186/s12884-022-04377-9.
Antenatal depression (AD) is common in pregnant women and is associated with adverse outcomes for the mother, fetus, infant and child. The influencing factors of AD among pregnant women have been studied; however, the mechanisms of these factors remain unclear. This study was designed to examine the direct and serial mediating roles of coping styles in the relationship between perceived social support and AD among pregnant women.
A cross-sectional study was conducted among 1486 pregnant women who registered to give birth at a tertiary hospital. A self-developed questionnaire was administered to obtain sociodemographic and obstetric data. The Perceived Social Support Scale (PSSS), Simplified Coping Style Questionnaire (SCSQ), and Edinburgh Postnatal Depression Scale (EPDS) were administered to measure the perceived social support, coping styles, and depressive symptoms of pregnant women, respectively. Multiple linear stepwise regression analysis was used, and then, the specific relationships among influencing factors were determined through structural equation modelling (SEM).
The prevalence of AD was 24.02%. The average scores of intrafamily support, extrafamily support, positive coping styles, negative coping styles and EPDS reported by pregnant women were 24.16 ± 3.09, 44.52 ± 6.16, 27.34 ± 4.89, 9.79 ± 3.82, and 7.44 ± 3.56, respectively. Multiple regression analysis showed that pregnant women with a higher level of intrafamily support exhibited a positive coping style and a decreased risk of AD. Compared with extrafamily support, the direct effect (-0.16 vs. -0.10, P < 0.05) and indirect effect of intrafamily support through coping styles (-0.028 vs. -0.027, P < 0.05) on AD were stronger. Two indirect pathways explained 17.46% of the variance in the EPDS scores.
Higher social support decreased the likelihood of AD, not only directly but also through the mediating roles of coping styles. Social support should be strengthened, and positive coping styles should be advocated in every stage of pregnancy. Specifically, intrafamily support should be given more attention for pregnant Chinese women.
产前抑郁（AD）在孕妇中很常见，与母亲、胎儿、婴儿和儿童的不良结局有关。已经研究了孕妇 AD 的影响因素，但这些因素的机制仍不清楚。本研究旨在探讨应对方式在孕妇感知社会支持与 AD 之间的直接和连续中介作用。
对一家三级医院登记分娩的 1486 名孕妇进行横断面研究。采用自设问卷获取孕妇的社会人口学和产科资料。采用感知社会支持量表（PSSS）、简易应对方式问卷（SCSQ）和爱丁堡产后抑郁量表（EPDS）分别测量孕妇的感知社会支持、应对方式和抑郁症状。采用多元线性逐步回归分析，然后通过结构方程模型（SEM）确定影响因素之间的具体关系。
AD 的患病率为 24.02%。孕妇家庭内支持、家庭外支持、积极应对方式、消极应对方式和 EPDS 的平均得分分别为 24.16±3.09、44.52±6.16、27.34±4.89、9.79±3.82和 7.44±3.56。多元回归分析显示，家庭内支持水平较高的孕妇表现出积极的应对方式，AD 的风险降低。与家庭外支持相比，家庭内支持对 AD 的直接效应（-0.16 对-0.10，P<0.05）和通过应对方式的间接效应（-0.028 对-0.027，P<0.05）更强。两个间接途径解释了 EPDS 评分方差的 17.46%。
较高的社会支持不仅直接降低了 AD 的可能性，而且还通过应对方式的中介作用降低了 AD 的可能性。应在妊娠的各个阶段加强社会支持，并倡导积极的应对方式。具体来说，应该更加关注中国孕妇的家庭内支持。
