Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1435-1444. doi: 10.1007/s00127-022-02269-z. Epub 2022 Apr 22.
Lack of social support is considered a potential risk factor for postnatal depression but limited longitudinal evidence is available. Pregnancy, when women have increased contact with healthcare services, may be an opportune time to intervene and help strengthen women's social networks to prevent feelings of depression postnatally, particularly for those at greatest risk. Our study examined the longitudinal relationship between social support in pregnancy and postnatal depression, and whether this is moderated by age or relationship status.
We analysed data collected from 525 women from a diverse inner-city maternity population in England who were interviewed in pregnancy and again three months postnatally. Women provided sociodemographic information and completed self-report measures of depression (Edinburgh Postnatal Depression Scale) and social support (Social Provisions Scale).
Less social support in pregnancy was associated with postnatal depression, after adjusting for sociodemographic confounders and antenatal depression (Coef. = - 0.05; 95% CI - 0.10 to - 0.01; p = 0.02). There was weak evidence of a moderating effect of relationship status. Subgroup analysis showed a stronger relationship between social support in pregnancy and postnatal depression for women who were not living with a partner (Coef. = - 0.11; 95% CI - 0.21 to - 0.01; p = 0.03) than for those who were (Coef. = - 0.03; 95% CI - 0.09 to 0.02; p = 0.28). Sensitivity analysis using multiple imputations to account for missing data confirmed the main results.
Interventions that target social support in pregnancy have the potential to reduce depression postnatally. Future research should explore in greater detail which women would benefit most from which type of social support.
缺乏社会支持被认为是产后抑郁的潜在风险因素，但目前纵向证据有限。怀孕时，女性与医疗保健服务的接触增加，这可能是一个干预的机会，可以帮助加强女性的社交网络，以防止产后出现抑郁情绪，尤其是对那些风险最大的女性。我们的研究调查了怀孕期间社会支持与产后抑郁之间的纵向关系，以及这种关系是否受到年龄或关系状况的调节。
我们分析了来自英国一个多元化的市中心产妇人群的 525 名女性的数据，这些女性在怀孕期间和产后三个月接受了访谈。女性提供了社会人口统计学信息，并完成了抑郁自评量表（爱丁堡产后抑郁量表）和社会支持自评量表（社会供应量表）。
在调整了社会人口统计学混杂因素和产前抑郁后，怀孕期间的社会支持较少与产后抑郁有关（系数= - 0.05；95%CI - 0.10 至 - 0.01；p = 0.02）。关系状况的调节作用存在微弱的证据。亚组分析显示，对于没有伴侣的女性，怀孕期间的社会支持与产后抑郁之间的关系更强（系数= - 0.11；95%CI - 0.21 至 - 0.01；p = 0.03），而对于有伴侣的女性，这种关系较弱（系数= - 0.03；95%CI - 0.09 至 0.02；p = 0.28）。使用多重插补来处理缺失数据的敏感性分析证实了主要结果。
针对怀孕期间社会支持的干预措施有可能降低产后抑郁的发生。未来的研究应更详细地探讨哪些女性最受益于哪种类型的社会支持。
