Medical School of Nantong University, Nantong, Jiangsu, China.
Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
BMC Womens Health. 2023 Sep 11;23(1):482. doi: 10.1186/s12905-023-02593-9.
Multiple factors may be responsible for the development of postpartum stress, including perceived social support, marital satisfaction, and maternal postnatal attachment. However, the underlying mediation mechanisms remain unclear. This study examined the complex relationships between perceived social support and postpartum stress among Chinese women.
A convenience sample comprising 406 postpartum women was recruited from six hospitals in Nantong, Jiangsu Province, China. The participants completed general survey questionnaires and were evaluated using the Maternal Postpartum Stress Scale, the Perceived Social Support Scale, the Maternal Postnatal Attachment Scale, and the Marital Satisfaction Scale. Furthermore, we evaluated the relationship between postpartum stress and the various influencing factors by performing a multiple linear regression analysis. The potential mediating roles of marital satisfaction and maternal and infant attachment in the association between perceived social support and postpartum stress were explored by performing a mediation analysis.
According to the multivariate regression analysis, perceived social support, marital satisfaction, and maternal postnatal attachment contributed to postpartum stress levels (P < 0.05). The mediation analysis revealed that marital satisfaction and maternal postnatal attachment played parallel mediating roles in the association between perceived social support and postpartum stress, and the mediating effect of marital satisfaction was - 0.1125 (95% confidence interval [CI]: -0.1784 to -0.0520), accounting for 33.20% of the total effect, and the mediating effect of maternal postnatal attachment was - 0.0847 (95% CI: -0.1304 to -0.0438), accounting for 25.00% of the total effect.
Our study revealed that perceived social support could influence postpartum stress not only through direct effect (41.80% of the total effect), but also through the indirect effect (mediation effect) of marital satisfaction and maternal postnatal attachment (58.20% of the total effect), suggesting that improving postpartum women's social support, enhancing maternal and infant attachment, and improving their marital satisfaction could help lower postpartum stress.
导致产后压力的因素可能有很多，包括感知到的社会支持、婚姻满意度和母婴依恋。然而，其潜在的中介机制尚不清楚。本研究调查了感知到的社会支持与中国女性产后压力之间的复杂关系。
采用便利抽样法，选取江苏省南通市六家医院的 406 名产后妇女为研究对象。采用一般情况调查问卷、母亲产后压力量表、感知社会支持量表、母婴依恋量表和婚姻满意度量表对其进行评估。此外，我们通过多元线性回归分析评估了产后压力与各种影响因素之间的关系。通过中介分析探讨了婚姻满意度和母婴依恋在感知社会支持与产后压力之间的关联中的潜在中介作用。
根据多元回归分析，感知社会支持、婚姻满意度和母婴依恋与产后压力水平有关（P<0.05）。中介分析表明，婚姻满意度和母婴依恋在感知社会支持与产后压力之间存在平行中介作用，婚姻满意度的中介效应为-0.1125（95%置信区间[CI]：-0.1784 至-0.0520），占总效应的 33.20%，母婴依恋的中介效应为-0.0847（95%CI：-0.1304 至-0.0438），占总效应的 25.00%。
本研究表明，感知社会支持不仅可以通过直接效应（总效应的 41.80%）影响产后压力，还可以通过婚姻满意度和母婴依恋的间接效应（中介效应）影响产后压力（总效应的 58.20%），提示改善产后妇女的社会支持、增强母婴依恋、提高婚姻满意度有助于降低产后压力。
