University Institute of Family Studies, Comillas Pontifical University, Madrid, Spain.
Department of Personality, Evaluation and Psychological Treatments, Complutense University of Madrid, Madrid, Spain.
Am J Perinatol. 2024 May;41(S 01):e2870-e2877. doi: 10.1055/s-0043-1776062. Epub 2023 Oct 17.
The aim of this research was to study the ways in which problems of adaptation to pregnancy influence the development of symptoms of perinatal depression via the presence of brooding and low maternal-fetal bonding, in addition to other risk factors previously established in the literature.
Representative sample of pregnant women in the third trimester of gestation ( = 594) completed an online survey that included sociodemographic data and measures of perinatal depression, adjustment to pregnancy, bonding, and brooding. Other risk factors were also assessed as covariates, such as previous history of depression, generalized anxiety, perceived social support, and experience of stressful life events. Descriptive and correlational analyses were performed on the scores obtained by the subjects with the different instruments. A path model was formulated to establish the pathways through which adjustment influences perinatal depression symptomatology. On the one hand, the presence of brooding (worst adjustment to pregnancy → high brooding → perinatal depression symptomatology), and on the other hand, the quality of maternal-fetal bonding (worst adjustment to pregnancy → poor quality fetal-maternal bonding → perinatal depression symptomatology) would act as a mediator.
The factors proposed by the literature were predictive of perinatal depressive symptomatology and the quality of adjustment to pregnancy. Problems adjusting to changes during pregnancy and experiencing it unsatisfactorily may predict individual differences in perinatal depressive symptoms. Significantly, this relationship was mediated by two key factors, the presence of brooding and low quality of the maternal-fetal bond.
Our results provide evidence in favor of the existence of multiple paths through which difficulties in adapting to pregnancy can favor the occurrence of higher levels of perinatal depressive symptoms and identify new avenues for developing research in this area and preventive interventions empirically informed.
本研究旨在探讨适应妊娠问题通过沉思和低母婴联系的存在对围产期抑郁症状发展的影响方式，此外还探讨了文献中先前确定的其他风险因素。
具有代表性的孕晚期（ = 594）孕妇完成了一项在线调查，其中包括社会人口统计学数据和围产期抑郁、妊娠适应、联系和沉思的测量。还评估了其他风险因素作为协变量，如既往抑郁症、广泛性焦虑、感知社会支持和经历压力性生活事件。对受试者在不同工具中获得的分数进行了描述性和相关性分析。制定了路径模型，以确定调整对围产期抑郁症状表现的影响途径。一方面，沉思的存在（对妊娠的调整最差→沉思程度高→围产期抑郁症状），另一方面，母婴联系的质量（对妊娠的调整最差→母婴联系质量差→围产期抑郁症状）将作为中介。
文献中提出的因素可预测围产期抑郁症状和妊娠适应质量。适应妊娠变化和体验不佳可能预测围产期抑郁症状的个体差异。重要的是，这种关系受到两个关键因素的中介，即沉思的存在和母婴联系质量差。
我们的研究结果支持了适应妊娠困难可能通过多种途径有利于发生更高水平的围产期抑郁症状的存在，并为该领域的研究和经验证的预防干预提供了新的途径。
