The Effect Of Infant Temperament And Maternal Perceived Stress On Postpartum Depression And The Intermediate Effect Of Social Support

Objective:To investigate the status of postpartum depression among puerperants.To explore the relationship between postpartum depression and infant temperament,perceived stress of puerperants.On the basis of the theory of psychological stress,the mechanism of postpartum depression is discussed by means of mediating effect and interaction effect.To further enrich the research results of postpartum depression and provide a theoretical basis for reducing the incidence of postpartum depression.Methods:Using convenient sampling,317 puerperants from 3 three fertility hospitals of Ji’nan city Shandong Province were conducted a questionnaire survey.They are 30～60 days after delivery.The survey tools including general information questionnaire,the Edinburgh postpartum depression scale(EPDS),the Infant Temperament Questionnaire(EITQ),Perceived Stress Scale(PSS),Social Support Rating Scale(SSRS).In this study,359 questionnaires were distributed,317 valid questionnaires,the effective percentage is 88.3%.The data are analyzed by spss19.0 and amos22.0.The statistical methods include descriptive statistical analysis,t-test,ANOVA,Pearson correlation analysis,regression analysis,path analysis of latent variables.Result:1.Social demographic and clinical information of puerperant and infantsA total of 359 questionnaires were distributed in this study.After disqualified and invalid questionnaires,317 pairs of mothers and infants were included in the study.The maternal age was between 20～44 years old,with an average age of(30.99±4.51).The occupation is mainly company employee or worker(45.1%),the type of medical insurance is mostly city medical insurance(44.8%).The average family income satisfaction rate was 52.4%.The infant weight was between 2080 and 4550g,with an average of(3411.55±422.77)g,and at the time of the survey,the birth age of the baby was 32～60 days,and the average was(46.31±6.04)days.The proportion of boys was 49.8.The gestational weeks of parturition were 37～41 weeks,with an average of(38.87 ±1.07)weeks;cesarean section was the most common mode of delivery,accounting for 64.4;the majority of women had a history of bad pregnancy and childbirth,accounting for 53.9;the majority of births were through childbirth,accounting for 53.9;the majority of postpartum appetite was better,accounting for 69.4 weeks;the majority of women had average sleep quality.Accounting for 54.3%and 10.7%for hypertensive disorder complicating pregnancy.2.Analysis of PPD and its difference in general data of parturient womenIn this study,the incidence of postpartum depression was 20.5%.T-test or ANOVA showed that family income satisfaction,postpartum appetite and sleep quality had significant effects on postpartum depression(P<0.001),and the worse the family income satisfaction,the worse the postpartum appetite,the worse the sleep quality.The higher the score of postpartum depression.3.The relationship between infant temperament,maternal perceived stress,social support and PPDPearson correlation analysis was made between 9 dimensions of infant temperament,perceived stress,total score of social support and each dimension of postpartum depression.The results show that there were significantly positively correlated between activity level of infants(r=0.123,P<0.05),phobotaxis(r=0.201,P<0.01),adaptability(r=0.176,P<0.01)、emotional(r=0.254,P<0.01)、sticking(r=0.216,P<0.01),the mother’s perceived stress(r=0.734,P<0.01),and PPD.There were significantly negative correlated between infant attention dispersion(r=-0.257,P<0.01)、social support(r=-0.391,P<0.01).4.Multiple stratified linear regression analysis of influencing factors of PPDSleep quality can positively predict postpartum depression,which can independently explain 14.7%of the variation of postpartum depression(β=0.387,t=6.331,P<0.001),and family income satisfaction can positively predict postpartum depression,which can independently explain 2.1%of the variation of postpartum depression(β=0.161,t=2.991,P=0.003).After the infant temperament incorporated into the equation,△R2 increased from 0.168 to 0.237.Infant temperament can explain 14.7%of the variation of postpartum depression.Perceived stress can positively predict postpartum depression,which can independently explain 31.8%of the variation of postpartum depression(β=0.640,t=14.816,P<0.001).Social support can negatively predict postpartum depression,which can independently explain 1.9%of the variation of postpartum depression(β=-0.158,t=-3.849,P<0.001).The model explained 57.4%of the variation of postpartum depression(P<0.001).5.The influence mechanism of infant temperament and maternal perceived stress on PPDInteraction between perceived stress and infant temperament on PPD,the results showed that there was no significant difference in the interaction between the dimensions of infant temperament and the effect of maternal perceived stress on PPD.The intermediary role of social support in the relationship between infant temperament and PPD,the results showed that social support acts as a completely intermediary between infant rhythm and PPD,Bootstrap output 95%CI was(0.115,0.553),P=0.003,Social support acts as a completely intermediary between infant emotional essence and PPD,Bootstrap output 95%CI was(0.043,0.157),P=0.001.Social support acts as a completely intermediary between infant persistence and PPD,Bootstrap output 95%CI was(0.125,0.492)P=0.001.Social support acts as a partly intermediary between infant attention dispersion and PPD,Bootstrap output 95%CI was(-0.284,-0.002),P=0.018.Social support acts as a partly intermediary between perceived stress and PPD,Bootstrap output 95%CI was(0.034,0.149),P=0.001.Conclusion:1.The incidence of postpartum depression was about 20.5%2.Infant temperament,maternal perceived stresst,social support can significantly predict PPD.3.There was no significant difference in the interaction between the dimensions of infant temperament and maternal perceived stress on PPD.4.Social support plays an intermediary role in the relationship between infant temperament(rhythm,emotional nature,persistence,attention to dispersion),maternal perceived stres and PPD.