Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study.

PURPOSE

Social support and self-esteem play crucial roles in influencing the mental health of pregnant women. This study explored the moderating role of social support and the mediating role of self-esteem in the relationship between pregnancy-related stress and antenatal depression among pregnant women.

METHODS

This cross-sectional study included 180 pregnant women who visited the obstetrics outpatient clinic at a hospital in Changwon, Korea, between November 22 and December 30, 2022. Data were collected through structured questionnaires that assessed antenatal depression, pregnancy stress, self-esteem, and social support. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and PROCESS Macro model 5.

RESULTS

The mean gestational age of the participants was 23 weeks. The mean score for pregnancy stress was 63.51±14.33, indicating a moderate level of self-esteem and social support were high, with scores of 31.06±4.83 and 41.96±7.73, respectively. Prenatal depression was notably low, averaging 6.51±4.59. It showed a significant positive correlation with pregnancy stress (r=.52, p<.001) and negative correlations with self-esteem (r=-.49, p<.001) and social support (r=-.24, p=.001). Self-esteem acted as a mediator in the relationship between pregnancy stress and antepartum depression among pregnant women, with an indirect effect of .05 and a 95% confidence interval of .02 to .08. Additionally, social support moderated the impact of pregnancy stress on antepartum depression (B=-.01, p=.036).

CONCLUSION

The study emphasizes the need for a comprehensive approach to maternal mental health during pregnancy, which should include stress management, self-esteem enhancement, and social support interventions. Addressing these interconnected factors is crucial for promoting maternal well-being and reducing the incidence of prenatal depression.