College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, Ethiopia.
School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
BMC Pregnancy Childbirth. 2023 May 22;23(1):372. doi: 10.1186/s12884-023-05708-0.
Prenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women.
Secondary data was obtained from 493 women who reported being pregnant in survey six of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders.
The mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05).
Social support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women's level of social support is beneficial.
产前压力会对孕妇的生活质量（QoL）产生负面影响。社会支持通过增强孕妇的压力应对能力，在改善其心理健康方面起着至关重要的作用。本研究评估了社会支持与健康相关生活质量（HRQoL）之间的关系，以及社会支持在孕妇感知压力与 HRQoL 之间的中介作用。
从澳大利亚妇女健康纵向研究（ALSWH）1973-78 年队列调查六期报告怀孕的 493 名女性中获得二次数据。使用医疗结局研究社会支持指数（MOS-SSS-19）和感知压力量表分别评估社会支持和感知压力。使用 SF-36 的心理成分量表（MCS）和生理成分量表（PCS）来检测心理和生理 HRQoL。采用中介模型检验社会支持在感知压力与 HRQoL 之间的中介作用。采用多变量分位数回归（QR）模型调整潜在混杂因素后，评估社会支持与 HRQoL 之间的关联。
孕妇的平均年龄为 35.8 岁。中介分析表明，情感/信息支持（β=-1.53；95%置信区间：-2.36，-0.78）、有形支持（β=-0.64；95%置信区间：-1.29，-0.09）和喜爱支持/积极的社会互动（β=-1.33；95%置信区间：-2.25，-0.48）在感知压力与心理健康相关 QoL 之间的关系中具有显著的中介作用。此外，感知压力通过整体社会支持对心理健康相关 QoL 具有显著的间接影响（β=-1.38；95%置信区间：-2.28，-0.56），且该中介因素约占总效应的 14.3%。多元 QR 分析表明，社会支持的所有领域和整体社会支持评分均与更高的 MCS 评分呈正相关（p<0.05）。然而，社会支持与 PCS 之间无显著关联（p>0.05）。
社会支持在改善澳大利亚孕妇的 HRQoL 方面起着直接和中介作用。孕产妇保健专业人员需要将社会支持视为改善孕妇 HRQoL 的重要工具。此外，作为常规产前保健活动的一部分，评估孕妇的社会支持水平是有益的。
