The role of social support in family socio-economic disparities in depressive symptoms during early pregnancy: Evidence from a Chinese birth cohort

被引:16
作者
Wei, Dong-Mei [1 ,2 ]
Yeung, Shiu Lun Au [1 ,3 ]
He, Jian-Rong [1 ,2 ]
Xiao, Wan-Qing [1 ,2 ]
Lu, Jin-Hua [1 ,2 ]
Tu, Si [1 ,2 ]
Chen, Nian-Nian [1 ,2 ]
Lam, Kin Bong Hubert [4 ]
Cheng, Kar-Keung [5 ]
Leung, Gabriel M. [3 ]
Xia, Hui-Min [1 ,6 ]
Schooling, C. Mary [3 ]
Qiu, Xiu [1 ,2 ]
机构
[1] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Div Birth Cohort Study, 9 Jinsui Rd, Guangzhou, Guangdong, Peoples R China
[2] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Woman & Child Hlth Care, 9 Jinsui Rd, Guangzhou, Guangdong, Peoples R China
[3] Univ Hong Kong, Li Ka Shing Fac Med, Sch Publ Hlth, Hong Kong, Hong Kong, Peoples R China
[4] Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England
[5] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England
[6] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Neonatal Surg, 9 Jinsui Rd, Guangzhou, Guangdong, Peoples R China
基金
中国国家自然科学基金;
关键词
PERINATAL DEPRESSION; RISK-FACTORS; HEALTH; WOMEN; ANXIETY;
D O I
10.1016/j.jad.2018.06.014
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Few studies have examined the association between a composite measure of family socio-economic position (SEP)(2) and depressive symptoms among Chinese pregnant women, nor any potential underlying mechanisms which may be amenable to preventative interventions. Methods: We investigated the association between a composite SEP measure and depressive symptoms during early pregnancy, and tested for mediation by social support and moderation by parity in the Born in Guangzhou Cohort Study (n=12,382) using adjusted logistic regression and causal mediation analysis. Results: In this population, 18.4% of women experienced depressive symptoms before the 20th gestational week. Compared with the highest quartile, the lowest SEP score quartile was associated with a higher risk of depressive symptoms (OR 1.50, 95% CI 1.31-1.71), which was more pronounced among multiparous women than nulliparous women (P for interaction < 0.001). Social support mediated the association between SEP and depressive symptoms, with greater proportion mediated in nulliparous women (73.4% for the lowest SEP score quartile) than multiparous women (30.5%). Limitations: Depressive symptoms were measured by Self-rated Depression Scale, which is not designed as a clinical diagnosis tool for depression. We only had information on perceived social support but not actual social support, although these two parameters were modestly correlated. Conclusion: Lower SEP was associated with higher risk of depressive symptoms in pregnant women, driven by social support. And the association between SEP and depressive symptoms and mediation by social support were modified by parity. Whether this association extends to the post pregnancy period or is amenable to cost-effective interventions should be investigated in further studies.
引用
收藏
页码:418 / 423
页数:6
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