Pekarsky Chloe, Skiffington Janice, Chaput Kathleen, Slater Donna, Leijser Lara M, Metcalfe Amy
Department of Obstetrics & Gynecology, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Birth. 2025 Mar;52(1):78-88. doi: 10.1111/birt.12862. Epub 2024 Aug 12.
Antenatal depression is the most prevalent pregnancy-associated mental health disorder. Previous studies have identified several risk factors for antenatal depression, including partner support. However, during the COVID-19 pandemic, many relationship dynamics changed. This study examined the extent to which relationship factors had an impact on antenatal depression in comparison with other well-researched factors in the context of the pandemic.
A secondary analysis was conducted using data from the P3 Cohort in Calgary, a longitudinal cohort study based in Alberta, Canada. Pregnant people (n = 872) completed self-report questionnaires and validated scales about sociodemographic, psychological, and relationship characteristics. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was used to assess the impact of reported characteristics on antenatal depression. Tests of model fit were used to examine whether the inclusion of variables related to relationship quality improved model fit after accounting for other known risk factors.
Overall, 18.23% of participants experienced antenatal depression. Relationship factors including relationship unhappiness (OR = 1.98 [95% CI: 1.06-3.69]), having an upsetting partner (OR = 2.00 [95% CI: 1.17-3.40]), and having a lower quality of relationships with close friends and family (OR = 1.76 [95% CI: 1.14-2.73]) were associated with antenatal depression; however, inclusion of these relationship factors did not improve model fit after accounting for other known predictors.
Overall, relationship factors were not associated with antenatal depression during the pandemic after accounting for other known risk factors. Stress and anxiety caused by the pandemic may have overshadowed the impact of relationship factors, or relationship factors may have contributed to higher levels of stress and anxiety more generally within our sample.
产前抑郁是最常见的与妊娠相关的心理健康障碍。先前的研究已经确定了产前抑郁的几个风险因素，包括伴侣支持。然而，在新冠疫情期间，许多人际关系动态发生了变化。本研究考察了在疫情背景下，与其他经过充分研究的因素相比，人际关系因素对产前抑郁的影响程度。
使用来自卡尔加里P3队列的数据进行二次分析，该队列研究是一项位于加拿大艾伯塔省的纵向队列研究。孕妇（n = 872）完成了关于社会人口学、心理和人际关系特征的自我报告问卷及经过验证的量表。使用爱丁堡产后抑郁量表（EPDS）评估产前抑郁。采用逻辑回归分析报告的特征对产前抑郁的影响。通过模型拟合检验来考察在考虑其他已知风险因素后，纳入与关系质量相关的变量是否能改善模型拟合。
总体而言，18.23%的参与者经历了产前抑郁。人际关系因素包括关系不幸福（OR = 1.98 [95% CI：1.06 - 3.69]）、伴侣令人心烦（OR = 2.00 [95% CI：1.17 - 3.40]）以及与亲密朋友和家人的关系质量较低（OR = 1.76 [95% CI：1.14 - 2.73]）与产前抑郁相关；然而，在考虑其他已知预测因素后，纳入这些人际关系因素并未改善模型拟合。
总体而言，在考虑其他已知风险因素后，疫情期间人际关系因素与产前抑郁无关。疫情引起的压力和焦虑可能掩盖了人际关系因素的影响，或者人际关系因素可能在我们的样本中更普遍地导致了更高水平的压力和焦虑。
