多中心研究：孕期夫妻抑郁率双高，家庭关系是关键

Prevalence, risk factors and family dynamics of antenatal depression in couples: A multicenter cross-sectional study

孕期夫妻抑郁的患病率、危险因素及家庭动态关系：一项多中心横断面研究

Authors: Chengli Tang, Mengru Wu, Rui Wu, Wenjing Qiang, Yongkang Liu, Yuan Liu, Houlin Zhang, Yifan Wang, Beibei Zhu, Fangbiao Tao

Source: Journal of Affective Disorders

PMID: 40543621

DOI: 10.1016/j.jad.2025.119702 

Abstract

Background: Parental depression during the perinatal period is a public health concern. This study aims to evaluate the prevalence of antenatal depression in couples, identify associated risk factors, and examine family dynamics, particularly marital and in-law relationships.

Methods: A cross-sectional, multicenter study conducted from November 2023 to June 2024 surveyed 2460 pregnant women and their partners in Anhui Province, China. The Edinburgh Postnatal Depression Scale (EPDS) was used for psychological assessment. Logistic regression identified risk factors for antenatal depression, and structural equation modeling (SEM) examined the direct and indirect effects of family relationships on antenatal depression.

Results: The prevalence of comorbid antenatal depression within couples was 3.3 %, with similar rates in women (16.4%) and men (14.6%). Key risk factors for both maternal and paternal depression included marital distress, unexpected pregnancy, a personal history of depression, and partner depressive symptoms. Additional risk factors for women were mother-in-law relationships, lower education, and lower household income. SEM analysis revealed that mother-in-law relationships had a direct effect on both marital distress (β=0.69, p<0.001) and depression in women (β=0.15, p<0.001). Furthermore, the indirect effect of mother-in-law relationships on maternal depression (β=0.12, p<0.001) was significantly stronger than that on paternal depression (β=0.02, p<0.001).

Conclusion: Maternal and paternal mental health during the perinatal period should be prioritized, especially in the presence of marital and in-law stressors. A family-centered care model with targeted psychological support may help mitigate antenatal depression.

Keywords: Antenatal depression; Couple comorbidity; Family dynamics; Prevalence; Risk factors.

摘要

背景：围产期父母抑郁是一个重要的公共卫生问题。本研究旨在评估夫妻孕期抑郁的患病率，识别相关危险因素，并探讨家庭动态关系，尤其是婚姻关系与婆媳关系的影响。

方法：本研究为多中心横断面调查，于2023年11月至2024年6月在中国安徽省开展，共纳入2460对孕妇及其配偶。采用爱丁堡产后抑郁量表（EPDS）评估心理状况，使用Logistic回归分析孕期抑郁的危险因素，结构方程模型（SEM）进一步分析家庭关系对孕期抑郁的直接与间接影响。

结果：夫妻共同患有孕期抑郁的比例为3.3%，孕妇和配偶的抑郁检出率分别为16.4%和14.6%。夫妻双方的共同危险因素包括婚姻困扰、意外妊娠、既往抑郁史及配偶抑郁症状。女性特有的风险因素还包括婆媳关系、低教育水平及低家庭年收入。SEM结果显示，婆媳关系对婚姻困扰（β=0.69，p<0.001）和女性抑郁（β=0.15，p< 0.001）具有直接影响；其对女性抑郁的间接影响（β= 0.12，p<0.001）显著高于对男性的影响（β=0.02，p< 0.001）。

结论：围产期需高度重视夫妻双方的心理健康，特别是在存在婚姻冲突和家庭压力的情况下。推动以家庭为中心的心理干预模式，有望缓解孕期抑郁的症状。

关键词：孕期抑郁；患病率；危险因素；家庭关系；夫妻共病