School of Nursing, Sun Yat-sen University, Guangzhou, China.
Nursing Department, Baoan People's Hospital, Shenzhen, China.
J Obstet Gynaecol. 2022 Nov;42(8):3456-3463. doi: 10.1080/01443615.2022.2135986. Epub 2022 Oct 29.
The aim of this study was to compare the depressive symptoms during pregnancy between pregnant women aged over 35 years and those aged less than 35 years and to evaluate the protective effect of social support in early pregnancy against prenatal depressive symptoms. One hundred and seventy one women aged over 35 years and 342 trimester-matched women aged less than 35 years were included from a level III hospital in Shenzhen, China. The self-report Edinburgh Postnatal Depression Scale (EPDS) and Social Support Rating Scale (SSRS) were used to evaluate prenatal depression and social support in early pregnancy. The proportions of women aged over 35 years who screened positive for prenatal depression were 22.8%, 23.4%, and 24.0% in the first, second and third trimesters, respectively. Advanced maternal age (≥35 years) was a positive predictor of prenatal depressive symptoms ( = 0.747, = 0,008). Social support, especially objective support ( = -0.030, = 0.002) and subjective support ( = -0.028, = 0.006) in early pregnancy, had stronger protective effects against prenatal depressive symptoms for women aged over 35 years than younger women. Our findings support that older pregnant women experience more depressive symptoms than younger pregnant women, and social support could serve as a targeted intervention to decrease prenatal depressive symptoms.Impact statement Depressive symptoms, which are strongly associated with adverse psychosocial and birth outcomes, appear to be prevalent and change in nature. Social support is an important protective factor against prenatal depression. Pregnant women of advanced maternal age experienced more depressive symptoms than younger women during the prenatal period. Social support, especially objective support and subjective support, had stronger protective effects against prenatal depression for women aged over 35 years than women aged less than 35 years. Screening of prenatal depression should be strengthened, especially for women aged over 35 years, and improving subjective support could improve their emotional experience.
本研究旨在比较 35 岁以上孕妇与 35 岁以下孕妇在孕期的抑郁症状，并评估孕早期社会支持对产前抑郁症状的保护作用。该研究纳入了来自中国深圳一家三级医院的 171 名 35 岁以上的孕妇和 342 名年龄匹配的 35 岁以下孕妇。采用自我报告的爱丁堡产后抑郁量表（EPDS）和社会支持评定量表（SSRS）评估孕妇在孕早期的产前抑郁和社会支持情况。第一、二、三孕期中，年龄 35 岁以上孕妇的产前抑郁检出率分别为 22.8%、23.4%和 24.0%。高龄产妇（≥35 岁）是产前抑郁的阳性预测因素（β=0.747，P=0.008）。社会支持，尤其是孕早期的客观支持（β=-0.030，P=0.002）和主观支持（β=-0.028，P=0.006）对年龄 35 岁以上孕妇的产前抑郁症状具有更强的保护作用，而对年龄小于 35 岁的孕妇则作用较弱。本研究结果表明，高龄孕妇比年轻孕妇更容易出现抑郁症状，社会支持可能是减少产前抑郁症状的一个有针对性的干预措施。
