Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum?

Figures & data

Table 1. Demographic characteristics of study participants (N = 1486).

Variables	Total, N (%)
Sociodemographic factors
Age (years)
M (SD)	32.9 (4.04)
20–29	282 (19.0)
30–39	1111 (75.0)
40–49	88 (5.9)
Education level
≤High school	254 (17.1)
≥College	1232 (82.9)
Employment status
Employed, full or part-time	114 (7.7)
Employed, maternity leave	511 (34.4)
Unemployed	861 (57.9)
Household income level (won/month)
<2,000,000	78 (5.2)
≥2,000,000 to <3,000,000	390 (26.2)
≥3,000,000 to <5,000,000	731 (49.2)
≥5,000,000	287 (19.3)
Maternal health-related factors
Parity
1	746 (50.2)
2	578 (38.9)
≥3	162 (10.9)
Method of conception
Natural pregnancy	1365 (91.9)
Artificial insemination or test-tube	121 (8.1)
Mode of delivery
Vaginal delivery	552 (37.1)
Cesarean section	934 (62.9)
Time elapsed after childbirth (months)
<1	88 (5.9)
≥1 to <2	175 (11.8)
≥2 to <3	179 (12.1)
≥3 to <6	433 (29.1)
≥6 to <12	611 (41.1)
Current maternal health problems
No	1051 (70.7)
Yes	435 (29.3)
Unplanned pregnancy
No	995 (67.0)
Yes	491 (33.0)
Miscarriage experience
No	1127 (75.8)
Yes	359 (24.2)
Social support factors (score range)	M (SD)
MSPSS total (12–60)	48.07 (9.57)
Family support (4–20)	16.47 (3.37)
Friend support (4–20)	15.16 (3.99)
Significant other support (4–20)	16.44 (3.35)

M: mean; MSPSS: Multidimensional Scale of Perceived Social Support; SD: standard deviation.

Table 2. Mental health of study populations (N = 1486).

Variables	Postpartum depression (K-EPDS)			Anxiety (GAD-7)			Perceived stress (PSS)
	None/normal (0–9)	Mild-moderate (≥10)	p Value^a	None/mild (0–9)	Moderate-severe (≥10)	p Value^a	None/mild (0–26)	Severe stress (≥27)	p Value^a
Total	893 (60.1)	593 (40.0)		1307 (88.0)	179 (12.0)		1364 (91.8)	122 (8.2)
Sociodemographic factors
Age (years)
20–29	169 (59.9)	113 (40.1)	.969	243 (86.2)	39 (13.8)	.553	257 (91.1)	25 (8.9)	.817
30–39	667 (60.0)	444 (40.0)		980 (88.2)	131 (11.8)		1021 (91.9)	90 (8.1)
40–49	54 (61.4)	34 (38.6)		79 (89.8)	9 (10.2)		82 (93.2)	6 (6.8)
Education level
≤High school	129 (50.8)	125 (49.2)	.001	1100 (89.3)	132 (10.7)	.001	226 (89.0)	28 (11.0)	.051
≥College	764 (62.0)	468 (38.0)		207 (81.5)	47 (18.5)		1138 (92.4)	94 (7.6)
Employment status
Employed, full or part-time	64 (56.1)	50 (43.9)	.120	100 (87.7)	14 (12.3)	.348	108 (94.7)	6 (5.3)	.122
Employed, maternity leave	325 (63.6)	186 (36.4)		458 (89.6)	53 (10.4)		476 (93.2)	35 (6.8)
Unemployed	504 (58.5)	357 (41.5)		749 (87.0)	112 (13.0)		780 (90.6)	81 (9.4)
Household income level (won/month)
<2,000,000	43 (55.1)	35 (44.9)	.012	60 (76.9)	18 (23.1)	<.001	69 (88.5)	9 (11.5)	.342
≥2,000,000 to <3,000,000	213 (54.6)	177 (45.4)		327 (83.8)	63 (16.2)		356 (91.3)	34 (8.7)
≥3,000,000 to <5,000,000	446 (61.0)	285 (39.0)		658 (90.0)	73 (10.0)		669 (91.5)	62 (8.5)
≥5,000,000	191 (66.6)	96 (33.4)		262 (91.3)	25 (8.7)		270 (94.1)	17 (5.9)
Maternal health-related factors
Parity
1	473 (63.4)	273 (36.6)	.030	660 (88.5)	86 (11.5)	.748	689 (92.4)	57 (7.6)	.669
2	326 (56.4)	252 (43.6)		507 (87.7)	71 (12.3)		526 (91.0)	52 (9.0)
≥3	94 (58.0)	68 (42.0)		140 (86.4)	22 (13.6)		149 (92.0)	13 (8.0)
Method of conception
Natural pregnancy	823 (60.3)	542 (39.7)	.332	1202 (88.1)	163 (11.9)	.383	1254 (91.9)	111 (8.1)	.407
Artificial insemination or test-tube	70 (57.9)	51 (42.1)		105 (86.8)	16 (13.2)		110 (90.9)	11 (9.1)
Mode of delivery
Vaginal delivery	332 (60.1)	220 (39.9)	.510	490 (88.8)	62 (11.2)	.256	511 (82.6)	41 (7.4)	.229
Cesarean section	561 (60.1)	373 (39.9)		817 (87.5)	117 (12.5)		853 (91.3)	81 (8.7)
Time elapsed after childbirth (months)^b
<1	63 (71.6)	25 (28.4)	.015	84 (95.5)	4 (4.5)	.200	86 (97.7)	2 (2.3)	.232
≥1 to <2	113 (64.6)	62 (35.4)		157 (89.7)	18 (10.3)		161 (92.0)	14 (8.0)
≥2 to <3	107 (59.8)	72 (40.2)		156 (87.2)	23 (12.8)		167 (93.3)	12 (6.7)
≥3 to <6	270 (62.4)	163 (37.6)		376 (86.8)	57 (13.2)		395 (91.2)	38 (8.8)
≥6 to <12	340 (55.6)	271 (44.4)		534 (87.4)	77 (12.6)		555 (90.8)	56 (9.2)
Current maternal health problems
No	695 (66.1)	356 (33.9)	<.001	958 (91.2)	93 (8.8)	<.001	992 (94.4)	59 (5.6)	<.001
Yes	198 (45.5)	237 (54.5)		349 (80.2)	86 (19.8)		372 (85.5)	63 (14.5)
Unplanned pregnancy
No	636 (63.9)	359 (36.1)	<.001	886 (90.0)	109 (11.0)	.041	920 (92.5)	75 (7.5)	.108
Yes	257 (52.3)	234 (47.7)		421 (85.7)	70 (14.3)		444 (90.4)	47 (9.6)
Miscarriage experience
No	677 (60.1)	450 (39.9)	.513	992 (88.0)	135 (12.0)	<.0476	1038 (92.1)	89 (7.9)	.249
Yes	216 (60.2)	143 (39.8)		315 (87.7)	44 (12.3)		326 (90.8)	33 (9.2)
Social support factors (M, SD)^c
MSPSS total	51.24 (7.98)	43.30 (9.79)	<.001	48.99 (9.11)	41.35 (10.20)	.002	48.78 (9.08)	40.14 (11.26)	<.001
Family support	17.58 (2.66)	14.80 (3.62)	<.001	16.81 (3.16)	14.01 (3.78)	.030	16.72 (3.16)	13.74 (4.29)	<.001
Friend support	16.06 (3.62)	13.66 (4.04)	.009	15.42 (3.90)	13.28 (4.10)	.291	15.38 (3.86)	12.70 (4.52)	.020
Significant other support	17.50 (2.75)	14.83 (3.54)	<.001	16.76 (3.16)	14.06 (3.73)	.089	16.68 (3.17)	13.70 (4.03)	.005

M: mean; MSPSS: Multidimensional Scale of Perceived Social Support; SD: standard deviation.

^a Differences in variables were tested using the Chi-squared test.

^b Fisher’s exact test was used when the expected values in any of the cells of a contingency table were below five.

^c Differences in variables were tested using the analysis of variance (ANOVA).

Table 3. Association between individual factors, social support, postpartum depression, anxiety and perceived stress.

Variable	Postpartum depression (K-EPDS)		Anxiety (GAD-7)		Perceived stress (PSS)
	Estimate	p Value	Estimate	p Value	Estimate	p Value
Sociodemographic factors
Age (years)	−0.002	.308	−0.001	.286	−0.004	.094
Education level
≥College	Ref.		Ref.		Ref.
≤High school	0.713	.043	0.753	.004	0.309	.397
Employment status
Employed, full or part-time	Ref.		Ref.		Ref.
Employed, maternity leave	−0.034	.950	−0.533	.180	−0.363	.511
Unemployed	0.043	.951	0.589	.251	0.465	.514
Household income level (won/month)
<2,000,000	0.482	.041	0.849	.001	0.728	<.001
≥2,000,000 to <3,000,000	0.503	.002	0.775	.006	0.417	.093
≥3,000,000 to <5,000,000	0.240	.101	0.073	.792	0.387	.176
≥5,000,000	Ref.		Ref.		Ref.
Maternal health-related factors
Parity
1	Ref.		Ref.		Ref.
2	1.339	.010	1.075	.673	1.195	.374
≥3	1.083	.637	1.163	.537	0.965	.907
Method of conception
Natural pregnancy	Ref.		Ref.		Ref.
Artificial insemination or test-tube	0.819	.095	0.513	.592	0.520	.353
Mode of delivery
Vaginal delivery	Ref.		Ref.		Ref.
Cesarean section	0.205	.005	0.117	.110	0.252	.417
Time elapsed after childbirth (months)
<1	Ref.		Ref.		Ref.
≥1 to <2	0.169	.327	0.087	.649	0.317	.074
≥2 to <3	0.373	.030	0.255	.077	0.128	.030
≥3 to <6	0.278	.036	0.463	.006	0.420	.028
≥6 to <12	0.697	.005	0.419	.023	0.468	.001
Current maternal health problems
No	Ref.		Ref.		Ref.
Yes	1.938	<.001	1.542	.008	2.895	<.001
Unplanned pregnancy
No	Ref.		Ref.		Ref.
Yes	0.818	.005	0.515	.023	1.138	<.001
Miscarriage experience
No	Ref.		Ref.		Ref.
Yes	0.440	.055	0.167	.563	0.379	.110
Social support factors^a
MSPSS total	−0.409	<.001	−0.920	<.001	−1.403	<.001
Family support	−0.541	<.001	−0.259	<.001	−0.344	<.001
Friend support	−0.103	.019	−0.024	.466	−0.135	.003
Significant other support	−0.251	.001	−0.178	.002	−0.298	<.001

K-EPDS: Korean version of the Edinburgh Postpartum Depression Scale; GAD-7: 7-item Generalized Anxiety Disorder Scale; PSS: Perceived Stress Scale.

^a Adjusted for age, education level, employment status, household income level, parity, time elapsed after childbirth, method of conception, mode of delivery, current maternal health problems, unplanned pregnancy and miscarriage experience.

Data availability statement

The data from this study cannot be made publicly available to protect participants’ information. Inquiries about the data can be referred to the corresponding author (HY, LEE, [email protected]).