Zhou Xinru, Sun Chang, Cai Zhengjie, Li Linhua, Wu Yuju, Zhang Hanwen, Raat Hein, Medina Alexis, Zhou Huan
Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Department of Gynecology and Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Psychiatry. 2025 Jun 2;16:1507991. doi: 10.3389/fpsyt.2025.1507991. eCollection 2025.
Maternal mental health issues have emerged as a public health concern garnering increasing attention in recent years, especially in low and middle-income countries (LMICs). The involvement of fathers and grandparents in infant care has been recognized as a key factor affecting maternal mental health. However, few studies have focused on the relationship between infant care assistance patterns and maternal mental health issues. This study aims to examine how infant care assistance patterns and its transitions over time affect maternal mental health in rural China.
This longitudinal study examined pregnant women in four rural Sichuan counties, China, using multi-stage random sampling to select 1054 mother-child dyads who completed baseline and follow-up assessments. We gathered four blocks of data: demographic characteristics, infant care assistance patterns (including sole maternal caregiving, joint parental caregiving, and maternal and grandparental caregiving), infant care assistance pattern transitions among mothers (including consistent assisted care, transitioned from sole mother care to assisted, transitioned from assisted care to sole mother, and sole mother care throughout) and maternal mental health issues (including depression, anxiety, and stress). Unordered multinomial logistic regression based on longitudinal data was used to explore the relationship between maternal mental health transitions and postnatal infant care assistance patterns transitions.
Of the mothers, 9.61% reported having severe depressive tendencies, 10.06% had moderate to severe anxious tendencies, and 4.65% reported having moderate to severe stress tendencies. Unordered multinomial logistic regression revealed that compared to mothers with consistent assisted care, those who transitioned from assisted care to sole mother care during the first-year postpartum experienced deterioration or a lack of improvement in depression (RRR=1.83, p<0.05), anxiety (RRR=2.07, p<0.05), and stress (RRR=2.37, p<0.01). Besides, mothers without assisted care throughout were also at higher risk of deteriorating or not improving in anxiety (RRR=1.86, p<0.05) and stress (RRR=2.36, p<0.05).
This study shows a link between infant care assistance patterns and maternal mental health. Mothers transitioning from assisted to sole care in the first postpartum year may face declining or stagnant psychological health, suggesting that family members offer support in infant care to share the caregiving responsibilities.
近年来，孕产妇心理健康问题已成为一个备受关注的公共卫生问题，在低收入和中等收入国家（LMICs）尤其如此。父亲和祖父母参与婴儿护理被认为是影响孕产妇心理健康的一个关键因素。然而，很少有研究关注婴儿护理协助模式与孕产妇心理健康问题之间的关系。本研究旨在探讨婴儿护理协助模式及其随时间的转变如何影响中国农村地区的孕产妇心理健康。
这项纵向研究对中国四川省四个农村县的孕妇进行了调查，采用多阶段随机抽样方法选取了1054对母婴二元组，这些母婴完成了基线和随访评估。我们收集了四类数据：人口统计学特征、婴儿护理协助模式（包括母亲独自照料、父母共同照料以及母亲和祖父母共同照料）、母亲之间的婴儿护理协助模式转变（包括持续获得协助照料、从母亲独自照料转变为获得协助照料、从获得协助照料转变为母亲独自照料以及全程母亲独自照料）以及孕产妇心理健康问题（包括抑郁、焦虑和压力）。基于纵向数据的无序多项逻辑回归用于探讨孕产妇心理健康转变与产后婴儿护理协助模式转变之间的关系。
在这些母亲中，9.61%报告有严重抑郁倾向，10.06%有中度至重度焦虑倾向，4.65%报告有中度至重度压力倾向。无序多项逻辑回归显示，与持续获得协助照料的母亲相比，那些在产后第一年从获得协助照料转变为母亲独自照料的母亲，在抑郁（相对风险比RRR = 1.83，p < 0.05）、焦虑（RRR = 2.07，p < 0.05）和压力（RRR = 2.37，p < 0.01）方面出现恶化或没有改善。此外，全程没有获得协助照料的母亲在焦虑（RRR = 1.86，p < 0.05）和压力（RRR = 2.36，p < 0.05）方面恶化或没有改善的风险也更高。
本研究表明婴儿护理协助模式与孕产妇心理健康之间存在联系。在产后第一年从获得协助照料转变为独自照料的母亲可能面临心理健康下降或停滞的情况，这表明家庭成员应在婴儿护理方面提供支持以分担照料责任。
