Department of Psychology, University of Oregon, Eugene, OR, United States of America.
Department of Psychology, University of Utah, Salt Lake City, UT, United States of America.
J Affect Disord. 2024 Nov 15;365:56-64. doi: 10.1016/j.jad.2024.08.059. Epub 2024 Aug 12.
Depressive symptoms during the perinatal period have broad and enduring health implications for birthing parents and their offspring. Rising prevalence rates of perinatal depression highlight the need for research examining factors influencing depressive symptoms during pregnancy, and trajectories during the early postnatal period. Grounded in bioecological systems theory, this longitudinal multimethod study examined whether prenatal bioecological factors predict depressive symptoms from pregnancy to 36 months postpartum.
Participants were 162 pregnant individuals, oversampled for high emotion dysregulation, who completed a life stress interview and physiological assessment during the 3rd trimester and a self-report measure of depression at five time-points (3rd trimester, within 48 h of birth, 7, 18, and 36 months postpartum). Multilevel models were used to test study aims.
Participants exhibited the highest levels of depressive symptoms at 3rd trimester, and substantial variability in depressive symptom trajectories over time. Lower resting respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, in the 3rd trimester was associated with higher concurrent depressive symptoms. Higher levels of stress related to partner relationships, finances, and health were concurrently associated with more depressive symptoms during pregnancy and decreases in depressive symptoms over time. Specifically, depressive symptoms decreased only for individuals who reported high levels of stress during pregnancy.
Although grounded in bioecological systems theory, this study did not assess the macrosystem.
Results of this study underscore the importance of multilevel predictors of perinatal health and highlights potential targets for preventing depression and promoting well-being during the perinatal transition.
围产期的抑郁症状对母婴及其后代的广泛和持久的健康都有影响。围产期抑郁的发病率不断上升，突显了需要研究影响怀孕期抑郁症状的因素以及产后早期的轨迹。本纵向多方法研究以生物生态系统理论为基础，探讨了产前生物生态因素是否能预测从怀孕到产后 36 个月的抑郁症状。
本研究纳入了 162 名高情绪失调的孕妇，在妊娠晚期进行生活压力访谈和生理评估，并在五个时间点（妊娠晚期、分娩后 48 小时内、7、18 和 36 个月时）进行自我报告的抑郁评估。使用多层次模型来检验研究目的。
参与者在妊娠晚期表现出最高水平的抑郁症状，且抑郁症状轨迹在时间上存在很大的可变性。妊娠晚期静息呼吸窦性心律失常（RSA）较低，这是副交感神经系统功能的指标，与较高的并发抑郁症状相关。与伴侣关系、财务和健康相关的较高压力水平与怀孕期间的抑郁症状增加以及抑郁症状随时间的下降有关。具体来说，只有在怀孕期间报告高压力水平的个体，抑郁症状才会下降。
尽管本研究以生物生态系统理论为基础，但它没有评估宏观系统。
这项研究的结果强调了围产期健康的多层次预测因素的重要性，并突出了预防围产期抑郁和促进围产期过渡期间幸福感的潜在目标。
