Mediating Effect Of Pregnancy Stress On The Relationship Between Social Support And Antenatal Depression In High-Risk Pregnant Women

Objective:By investigating the status quo of social support,pregnancy stress,and antenatal depression among pregnant women with high-risk pregnancy,the correlation between social support,pregnancy stress and antenatal depression was analyzed,and the mediating effect of pregnancy stress on social support and antenatal depression was explored.Provide reference for clinical intervention of antenatal depression.Methods:The convenience sampling method was used to select 260 high-risk pregnant women who visited the obstetrics department of a tertiary first-class hospital in Sichuan Province from June to October 2021 as the research objects to carry out a questionnaire survey.The survey tools included the General Information Questionnaire,the Perceived Social Support Scale,the Pregnancy Stress Scale,and the Edinburgh Postpartum Depression Scale.The data was entered using Excel 2016 software,and SPSS 26.0 was used for statistical description,two-sample Mann-Whitney U or multi-sample Kruskal-Wallis H rank-sum test,multiple linear regression analysis,Spearson correlation analysis,and hierarchical regression analysis;constructed with AMOS 23.0 software Structural equation modeling,using Bootstrap method to analyze the mediating effect of pregnancy stress between social support and antenatal depression in high-risk pregnant women.Results:1.The social support score of pregnant women with high-risk pregnancy is 64.00(57.00,70.00),which is at a high level.The scores of each dimension from high to low are family support,other support,and friend support.There were significant differences in the total score of social support in terms of work status,medical expenses payment method,pregnancy risk assessment,conception method,relationship between husband and wife,relationship with in-laws,relationship with parents,sleep during pregnancy,and family housing conditions(P<0.05)..The results of multiple stepwise regression analysis showed that relationship with in-laws,relationship with parents,sleep status during pregnancy and work status were the main factors affecting social support of pregnant women with high-risk pregnancy.2.The pregnancy stress score of high-risk pregnant women is 0.57(0.33,0.87),which is a mild level.The scores of each dimension from high to low are maternal and child safety,physical aspects,other aspects,and role identity.There were significant differences in the total score of pregnancy stress in terms of conception mode,parity,number of fetuses,pregnancy mode,relationship with in-laws,sleep during pregnancy,and family housing conditions(P<0.05).The results of multiple stepwise regression analysis showed that sleep during pregnancy,the number of gestational fetuses,parity,and the relationship with in-laws were the main factors affecting pregnancy stress in pregnant women with high-risk pregnancy.3.The antenatal depression score of high-risk pregnant women was 8.00(6.00,10.00),and the incidence rate was 37.4%.There were significant differences in antenatal depression scores in terms of work status,payment method of medical expenses,hospitalization experience during pregnancy,relationship between husband and wife,relationship with in-laws,relationship with parents,and sleep during pregnancy(P<0.05).The results of multiple stepwise regression analysis showed that sleep status during pregnancy,marital relationship,and hospitalization experience during pregnancy were the main factors affecting antenatal depression in high-risk pregnant women.There were significant differences in social support and pregnancy stress scores in high-risk pregnancies between the depressed and non-depressed groups.4.The social support of high-risk pregnant women was negatively correlated with antenatal depression(r=-0.461,P<0.01),and social support was negatively correlated with pregnancy stress(r=-0.377,P<0.01),and pregnancy stress was positively correlated with prenatal depression(r=0.471,P<0.01).5.The results of the structural equation show that social support has a negative effect on antenatal depression in high-risk pregnant women(β=-0.578,P<0.001),and social support can have an indirect negative effect on high-risk pregnant women through pregnancy stress(β=-0.178,P<0.001),suggesting that pregnancy stress played a partial mediating effect between social support and antenatal depression in high-risk pregnant women,accounting for 30.79%of the total effect.Conclusions:1.High-risk pregnant women have a high level of social support,but more attention should be paid to high-risk pregnant women who have a discordant relationship with their in-laws and parents,who are not working,and who have poor sleep during pregnancy.2.Pregnancy stress in high-risk pregnancy is a mild stress level,but more attention should be paid to high-risk pregnant women who have a discordant relationship with their in-laws,twin pregnancy,primipara and poor sleep during pregnancy.3.The incidence of antenatal depression in high-risk pregnant women is higher,and attention should be paid to high-risk pregnant women with disharmonious relationship between husband and wife,poor sleep during pregnancy,and hospitalization during pregnancy.4.There is a significant correlation between social support and pregnancy stress in high-risk pregnant women and antenatal depression,and social support can have a direct impact on antenatal depression,and can indirectly affect antenatal depression through pregnancy stress.Therefore,medical staff can start from the perspective of pregnancy stress,make full use of social support providers,provide social support to pregnant women with high-risk pregnancy,adjust their cognition of stressors,help reduce pregnancy stress,and thus prevent the occurrence of antenatal depression.