Abstract
BackgroundPrenatal depression is associated with adverse maternal and fetal health consequences, yet it has not raised sufficient concerns in China. Psychological worries and stress may lead to prenatal depression, but resilience could relieve some of the negative effects of worries and stress and mitigate prenatal depression.AimsThis study aimed to assess the prevalence of prenatal depression and explore its associated factors.MethodA multisite cross-sectional study was conducted that included 605 pregnant women from three hospitals in two provincial capitals (Shenyang and Zhengzhou) and one municipality (Chongqing). A smartphone questionnaire was employed to assess prenatal depression using the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate logistic regression analysis was performed to explore factors associated with prenatal depression.ResultsThe prevalence of prenatal depression (CES-D≥16) among Chinese pregnant women was 28.4%. Logistic regression analyses revealed that prenatal depression was positively associated with worries about appearance (odds ratio [OR] 1.666, 95% confidence interval [CI] 1.043–2.661) and perceived stress (OR 1.156, 95% CI 1.104–1.211) and negatively associated with monthly income, relationship with mother (OR 0.287, 95% CI 0.103–0.796), and resilience (OR 0.935, 95% CI 0.918–0.953).ConclusionThese findings revealed that Chinese pregnant women suffered from high levels of prenatal depression (28.4%). Worries about appearance and perceived stress were risk factors for prenatal depression, whereas a pregnant woman’s harmonious relationship with her own mother and resilience could relieve the negative impacts of pregnancy that can lead to prenatal depression. Improving resilience and maintaining harmonious relationships with mothers should be emphasized in order to reduce the detrimental effects of pregnancy and improve the mental well-being of pregnant women.
Highlights
Most pregnant women experience emotional worries and stress during pregnancy: new responsibilities related to their lives and family expectations may lead to depression in both prenatal and postnatal periods [1]
Previous studies indicated that prenatal depression was a strong predictor of postnatal depression, but prenatal depression is more prevalent than postnatal depression [7]
According to the social-ecological model, variables predicting the prevalence of prenatal depression can be categorized into individual factors [11], interpersonal factors, and coping and appraisal skills
Summary
Most pregnant women experience emotional worries and stress during pregnancy: new responsibilities related to their lives and family expectations may lead to depression in both prenatal and postnatal periods [1]. Substantial changes in body function and appearance and worries about fetal health pose great challenges to psychological health, which can result in mental disorders such as depression and anxiety [2, 3]. According to the social-ecological model, variables predicting the prevalence of prenatal depression can be categorized into individual factors [11] (such as demographic characteristics, pregnancy status, and worries and stress surrounding pregnancy), interpersonal factors (such as relationships with family members and emotional support), and coping and appraisal skills (such as positive psychological abilities, like resilience, that have the potential to enable women to resume normal functioning and engage in activities that help them respond effectively to the process of adaptation). Appearance changes, and the negative impacts of pregnancy on daily life may have detrimental effects on the prevalence of prenatal depression. Psychological worries and stress may lead to prenatal depression, but resilience could relieve some of the negative effects of worries and stress and mitigate prenatal depression
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