Jiang Man, Chen Lei, Tuo Nan, Yang Dongjian, Liu Shimeng, Huang Zhen
Eye & ENT Hospital, Fudan University, Shanghai, China.
School of Public Health, Fudan University, Shanghai, China.
Psychiatry Investig. 2025 Mar;22(3):221-230. doi: 10.30773/pi.2024.0205. Epub 2025 Mar 18.
Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood.
This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken.
In the final SEM demonstrating satisfactory fit, three stressors-decreased household income, insufficient daily supplies, and acquired infections-showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies.
This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.
数百个国家已实施封锁政策以减缓2019冠状病毒病（COVID-19）的传播，但这些措施对孕产妇心理健康的影响尚不清楚。
本研究整合了一个压力过程模型，以检验从与封锁相关的压力源到产前心理结果的路径，将COVID-19应对策略（COP）和管理负面影响的自我效能感（NEG）作为中介变量，将封锁持续时间、在大流行相关信息上花费的时间以及怀孕次数作为调节变量。上海的孕妇完成了情绪调节自我效能量表、COVID-19应对量表、抑郁、焦虑和压力量表-21。采用结构方程模型（SEM）对假设模型进行检验和修正，并进行调节中介分析和斜率分析。
在最终拟合良好的SEM中，三个压力源——家庭收入减少、日常用品不足和感染——与NEG和COP呈正相关。感染、NEG和COP被确定为心理健康结果的直接预测因素。这三个压力源与心理健康之间的关系由NEG和COP介导。此外，怀孕次数调节了COP的中介作用；这种效应在初产妇中比多产妇中更明显。
本研究深入探讨了封锁措施如何影响居家隔离孕妇的心理结果。在未来的公共卫生紧急事件中，旨在增加应对策略的干预措施可能对初产妇更有效。
