The Role of Maternal Perceived Social Support on the Relation Between Prenatal Depressive Symptoms and Labor Experience
Abstract
Abstract.Background: Depression during pregnancy is a severe risk factor for negative outcomes in women and children. In particular, prenatal symptoms of depression are linked to a more complicated labor experience, characterized by more painful labor and more frequent recourse to epidural analgesia and/or oxytocin. Although this link is evident, less is known about possible mediators of this relationship. Aims: This study investigated the mediating role of perceived maternal social support on the relationship between prenatal maternal depression and labor experience. Methods: Participants were 152 Italian nulliparous women (Mage = 31.68 years, SD = 4.94). Data were collected at two different times: T1 (at week 30–33 of gestation) women completed the Beck Depression Inventory and the Maternal Social Support Scale; T2 (at childbirth) clinical data regarding labor was registered from hospital records (duration of labor in hours and administration of oxytocin and epidural analgesia in hours). Results: The Structural Equation Modeling showed that prenatal symptoms of depression are linked to a more complicated labor experience (β = .31, p < .001). However, the quality of the maternal social support can mediate this relationship (indirect effect: β = .17, p < .000). Limitations: The complexity of the proposed model, the characteristics of the sample, the variables investigated, and the questionnaires used are discussed. Conclusion: The perception of having a good social network is an important predictor of women’s health in the transition to motherhood, decreasing the negative effect of maternal prenatal depressive symptoms on the quality of women’s labor experience.
References
2016). Perinatal depression: A clinical update. The Nurse Practitioner, 41(5), 50–55. doi: https://doi.org/10.1097/01.NPR.0000480589.09290.3e
(2011). Epidural versus non-epidural or no analgesia in labor. Cochrane Database of Systematic Reviews, Dec(12). https://doi.org/10.1002/14651858.CD000331.pub3
(2018). The relationship between perceived social support in the first pregnancy and fear of childbirth. Iranian Journal of Nursing and Midwifery Research, 23(3), 235–239. https://doi.org/10.4103/ijnmr.IJNMR_170_16
(2009). Sports participation as a protective factor against depression and suicidal ideation in adolescents as mediated by self-esteem and social support. Journal of Developmental & Behavioral Pediatrics, 30(5), 376–384. https://doi.org/10.1097/DBP.0b013e3181b33659
(2007). Social support networks and maternal mental health and well-being. Journal of Women’s Health, 16(10), 1386–1396. https://doi.org/10.1089/jwh.2007.CDC10
(1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173
(1996). BDI-II, Beck Depression Inventory-II. Psychological Corporation.
(1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. https://doi.org/10.1037/0033-2909.107.2.238
(1995). EQS structural equations program manual. Multivariate Software.
(2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843–857. https://doi.org/10.1016/s0277-9536(00)00065-4
(2004). Perinatal risks of untreated depression during pregnancy. The Canadian Journal of Psychiatry, 49(11), 726–735. https://doi.org/10.1177/070674370404901103
(2016). Mental health care use in relation to depressive symptoms among pregnant women in the USA. Archives of Women’s Mental Health, 19(1), 187–191. https://doi.org/10.1007/s00737-015-0524-1
(2016). Antenatal depression: Prevalence and risk factor patterns across the gestational period. Journal of Affective Disorders, 192, 70–75. https://doi.org/10.101610.1016/j.jad.2015.12.017
(2000). Psychosocial predictors of labor/delivery complications and infant birth weight: a prospective multivariate study. Journal of Psychosomatic Obstetrics & Gynecology, 21(3), 137–148. https://doi.org/10.3109/01674820009075621
(2012). Oxytocin augmentation of labour in women with epidural analgesia for reducing operative deliveries. Cochrane Database of Systematic Reviews, May(5), 1–14. https://doi.org/10.1002/14651858.CD009241.pub2
(2009). Il Supporto Sociale in Gravidanza: Validazione italiana e valutazione dello strumento
([Social Support during pregnancy: The Italian validation and evaluation of the instrument] . Giornale di Psicologia, 3(2), 141–151.2017). Prenatal depression risk factors, developmental effects and interventions: a review. Journal of Pregnancy and Child Health, 4(1), 1–25. https://doi.org/10.4172/2376-127X.1000301
(2009). Pain in childbirth and postpartum recovery–The role of catastrophizing. European Journal of Pain, 13(3), 312–316. https://doi.org/10.1016/j.ejpain.2008.04.010
(2021). Thinking for three: Mothers’ and fathers’ narratives on transition to parenthood. The Open Psychology Journal, 14, 53–61. https://doi.org/10.2174/1874350102114010053
(2006). Beck Depression Inventory – Second Edition. Italian adaptation: Manual. Organizzazioni Speciali.
(2011). Social support and social negativity findings in depression: Perceived responsiveness to basic psychological needs. Clinical psychology review, 31(3), 342–352. https://doi.org/10.1016/j.cpr.2011.01.005
(2014). Relationship between perceived social support in first pregnancy with birth satisfaction in primigravid women referred to Shahid Akbar Abadi Hospital. Preventive Care in Nursing & Midwifery Journal, 4, 53–64.
(2011). Validity of depression rating scales during pregnancy and the postpartum period: Impact of trimester and parity. Journal of Psychiatric Research, 45(2), 213–219. https://doi.org/10.1016/j.jpsychires.2010.05.017
(2018). Labor pain in women with and without severe fear of childbirth: A population-based, longitudinal study. Birth, 45(4), 469–477. https://doi.org/10.1111/birt.12349
(2020). Maternal antenatal depression and early childhood sleep: Potential pathways through infant temperament. Journal of Pediatric Psychology, 45(2), 203–217. https://doi.org/10.1093/jpepsy/jsaa001
(2015). Principles and practice of structural equation modeling. Guilford Publications.
(2016). The mediating role of social support in the relationship between psychological well-being and health-risk behaviors among Chinese university students. Health Psychology Open, 3(2), 1–11. https://doi.org/10.1177/2055102916678106
(2008). Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry, 8(1), Article 24. https://doi.org/10.1186/1471-244X-8-24
(2013). Social support, life events, and depression. Academic Press.
(2016). Women’s experience of childbirth – a five year follow-up of the randomised controlled trial “ready for child trial”. Women and Birth, 29(5), 450–454. https://doi.org/10.1016/j.wombi.2016.02.003
(2011). High dose versus low dose oxytocin for augmentation of delayed labour. Cochrane Database of Systematic Reviews, (10). https://doi.org/10.1002/14651858.CD007201.pub2
(1998–2007). Mplus user’s guide (7th ed.). Muthén & Muthén.
(2000). The funds, friends, and faith of happy people. American Psychologist, 55(1), 56–67. https://doi.org/10.1037/0003-066X.55.1.56
(2008). Induction of labour. National Collaborating Centre for Women’s and Children’s Health. National Institute for Health and Clinical Excellence. RCOG Press.
. (1994). Psychometric theory. McGraw Hill.
(2019). Postnatal depressive symptoms in women with and without antenatal depressive symptoms: Results from a prospective cohort study. Archives of Women’s Mental Health, 22(1), 93–103. https://doi.org/10.1007/s00737-018-0880-8
(2009). Depression during pregnancy: Prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil. Cadernos de Saude Publica, 25(12), 2725–2736. https://doi.org/10.1590/s0102-311x2009001200019
(2010). Do parents and school matter? Protective factors for adolescent substance use. Addictive Behaviors, 35(1), 53–56. https://doi.org/10.1016/j.addbeh.2009.08.004
(2016). Prenatal maternal depression is associated with offspring inflammation at 25 years: A prospective longitudinal cohort study. Translational Psychiatry, 6, Article 936. https://doi.org/10.1038/tp.2015.155
(2019). Mediating role of labor on the relationship between prenatal psychopathologic symptoms and symptoms of postpartum depression in women who give birth vaginally. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(6), 627–634. https://doi.org/10.1016/j.jogn.2019.09.003
(2020). The relationship between romantic and prenatal maternal attachment: The moderating role of social support. International Journal of Psychology, 56(1), 1–8. https://doi.org/1-8.10.1002/ijop.12676
(2013). The influence of general anxiety and childbirth-specific anxiety on birth outcome. Archives of Women’s Mental Health, 16(5), 363–369. https://doi.org/10.1007/s00737-013-0344-0
(2017). The predictive role of support in the birth experience: A longitudinal cohort study. Women and Birth, 30(6), 450–459. https://doi.org/10.1016/j.wombi.2017.04.003
(2019). A comprehensive analysis of post-partum depression risk factors: The role of socio-demographic, individual, relational, and delivery characteristics. Frontiers in Public Health, 7, Article 295. https://doi.org/10.3389/fpubh.2019.00295
(2019a). Maternal depressive symptomatology during pregnancy is a risk factor affecting newborn’s health: a longitudinal study. Journal of Reproductive and Infant Psychology, 37(4), 444–452. https://doi.org/10.1080/02646838.2019.1581919
(2019b). The effect of maternal depression and anxiety on labour and the well-being of the newborn. Journal of Obstetrics and Gynaecology, 39(4), 492–497. https://doi.org/10.1080/01443615.2018.1536697
(2020). The mother-child attachment bond before and after birth: The role of maternal perception of traumatic childbirth. Early Human Development, 142, 1–5. https://doi.org/10.1016/j.earlhumdev.2020.104956
(1980, May). Statistically-based tests for the number of common factors. Paper presented at the Annual Meeting of the Psychometric Society, Iowa City, IA.
(2017). Maternal social support, quality of birth experience, and post-partum depression in primiparous women. The Journal of Maternal-Fetal & Neonatal Medicine, 30(6), 689–692. https://doi.org/10.1080/14767058.2016.1182980
(2017). Mothers’ social perceived support, anxiety and prenatal attachment to child: Which direct and indirect influences on delivery clinical indices. International Journal of Health Sciences and Research, 7, 346–352.
(1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10. https://doi.org/10.1007/BF02291170
(2000). Measuring social support in pregnancy: can it be simple and meaningful? Birth, 27(2), 97–101. https://doi.org/10.1046/j.1523-536x.2000.00097.x
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