出生满意度与婚姻满意度在妊娠压力和产后抑郁的中介效应

Mediating role of birth satisfaction and marital satisfaction in the relationship between pregnancy stress and postpartum depression

目的:探讨出生满意度与婚姻满意度在妊娠压力和产后抑郁间的平行中介作用,为制定有针对性的干预措施降低产妇产后抑郁提供参考。方法:于2023年2-6月采用方便抽样的方法选取孕晚期女性为研究对象,使用一般资料调查表、妊娠压力量表调查产妇孕晚期资料和妊娠压力,并采用生育满意度量表-修订指标、婚姻满意度量表、产后抑郁量表评估产妇的出生满意度、婚姻满意度和产后抑郁状况。结果:共有635例产妇完成了两次问卷调查,产妇孕晚期妊娠压力评分为0.41±0.37分,出生满意度评分为8.54±2.16分,婚姻满意度评分为42.46±6.34分,抑郁评分为4.35±4.57分。产妇产后抑郁与妊娠压力呈正相关(r=0.390,P<0.001),与出生满意度(r=-0.331,P<0.001)、婚姻满意度(r=-0.503,P<0.001)呈负相关。经中介效应检验,妊娠压力对产后抑郁的直接效应显著,效应值为2.784,出生满意度与婚姻满意度在妊娠压力和产后抑郁中起平行中介作用,中介效应值分别为0.554,1.506,中介效应占总效应的42.53%。结论:妊娠压力可预测产妇产后抑郁,既包括妊娠压力的直接效应,也包括出生满意度与婚姻满意度的间接效应。

Objective:To explore the parallel mediating role of birth satisfaction and marital satisfaction in the relationship between pregnancy stress and postpartum depression.It provides references for targeted interventions to reduce postpartum stress among mothers.Methods:From February to June 2023,a convenient sampling method was used to select pregnant women in the late stages of pregnancy as the study subjects.General demographic information,prenatal stress levels,birth satisfaction,marital satisfaction,and postpartum depression were measured using questionnaires and scales.Results:A total of 635 postpartum women completed two questionnaire surveys.The score for late pregnancy stress in the postpartum women was 0.41±0.37,the score for birth satisfaction was 8.54±2.16,the score for marital satisfaction was 42.46±6.34,and the score for depression was 4.35±4.57.Postpartum depression was positively correlated with prenatal stress(r=0.390,P<0.001)and negatively correlated with birth satisfaction(r=-0.331,P<0.001)and marital satisfaction(r=-0.503,P<0.001).According to the mediation effect test,the direct effect of pregnancy stress on postpartum depression was significant,and the effect value was 2.784.The mediating effect of birth satisfaction and marriage satisfaction on pregnancy stress and postpartum depression was 0.554 and 1.506 respectively,and the mediating effect accounted for 42.53%of the total effect.Conclusion:Pregnancy stress can predict postpartum depression,including both the direct effect of pregnancy stress and the indirect effect of birth satisfaction and marital satisfaction.