Association Between Perceived Stress and Prenatal Depressive Symptoms: Moderating Effect of Social Support

Figures & data

Table 1 Characteristic of Participants by Depression Symptoms (N = 1846)

Characteristic	Total n (%)	Depressive Symptoms^a		χ^2	p
		With n (%)	Without n (%)
Total	1846 (100.0)	521 (28.2)	1325 (71.8)	NA	NA
Maternal age, years ^b	29.22 (4.4)	28.58 (4.4)	29.475 (4.3)	3.97	<0.001
Gestational age, weeks ^b	25.92 (1.5)	25.9 (1.4)	25.92 (1.5)	0.24	0.809
Education level				8.267	0.016
Junior high school or below	373 (20.2)	121 (23.3)	252 (19.1)
Senior high school	393 (21.3)	123 (23.7)	270 (20.5)
College or university	1071 (58.0)	276 (53.0)	795 (60.4)
Missing data	9 (0.5)	NA	NA
Work status				8.875	0.002
Not working	325 (17.6)	114 (21.9)	211 (16.0)
Working	1511 (81.9)	406 (78.1)	1105 (84.0)
Missing data	10 (0.5)	NA	NA
Household income per capita, CNY/month				3.489	0.175
<5000	713 (38.6)	215 (41.4)	498 (37.8)
5001~10,000	779 (42.2)	220 (42.3)	559 (42.4)
>10,000	345 (18.7)	85 (16.4)	260 (19.6)
Missing data	9 (0.5)	NA	NA
Marital status				0.006	0.939
Married	1817 (98.4)	513 (98.5)	1304 (98.4)
Unmarried or divorced	29 (1.6)	8 (1.5)	21 (1.6)
Exercise, hour/day				0.416	0.519
<0.5 hours	1095 (59.3)	303 (58.3)	792 (59.9)
≥0.5 hours	747 (40.5)	217 (41.7)	530 (40.1)
Missing data	4 (0.2)	NA	NA
Passive smoking				10.796	0.001
No	1467 (79.5)	389 (75.1)	1078 (81.9)
Yes	367 (19.8)	129 (24.9)	238 (18.1)
Missing data	12 (0.7)	NA	NA

Notes: ^aDepressive symptoms was defined as an EPDS score ≥ 9. ^bMaternal age and gestational age are presented as means (standard deviation), and compared using the t-tests.

Abbreviations: CNY, China Yuan; NA, not applicable or no data available.

Table 2 Perceived Stress and Social Support in Pregnant Women (N = 1846)

Characteristic	Total Mean (SD)	Depressive Symptoms^a		t	p
		With (n = 1325) Mean (SD)	Without (n = 521) Mean (SD)
PSS-14 score	21.15 (5.9)	25.08 (5.43)	19.6 (5.32)	19.83	<0.001
SSRS score	42.28 (6.58)	39.48 (6.34)	43.38 (6.34)	11.89	<0.001
SSRS components
Subjective support	24.31 (4.17)	22.75 (4.25)	24.93 (3.98)	10.36	<0.001
Objective support	10.07 (2.84)	9.31 (2.61)	10.37 (2.87)	7.67	<0.001
Usage of support	7.89 (1.68)	7.42 (1.56)	8.08 (1.69)	8.01	<0.001

Notes: ^aDepressive symptoms was defined as an EPDS score ≥ 9.

Abbreviations: PSS, perceived stress scale; SSRS, social support rating scale; EPDS, Edinburgh postnatal depression scale; SD, standard deviation.

Table 3 Associations Between Perceived Stress, Social Support, and Depressive Symptoms

Variable	Model 1 (n=1846)^a		Model 2 (n=1831)^b		Model 3 (n=1831)^c
	COR (95% CI)	p	AOR (95% CI)	p	AOR (95% CI)	p
Perceived stress	1.230 (1.200–1.261)	< 0.001	1.210 (1.178–1.242)	< 0.001	1.208 (1.176–1.240)	< 0.001
Social support	0.908 (0.893–0.924)	< 0.001	0.950 (0.932–0.968)	< 0.001	0.955 (0.935–0.976)	< 0.001
Perceived stress *Social support	NA	NA	NA	NA	NA	< 0.001

Notes: ^aModel 1: Univariate logistic regression, not adjusted for covariates. ^bModel 2: Adjusted for maternal age, gestational age, education level, work status, household income per capita, marital status, exercise, and passive smoking. ^cModel 3: Adjusted for the covariates in Model 2 plus the interaction item of perceived stress and social support.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; NA, not applicable or no data available.

Table 4 Association Between Perceived Stress and Depressive Symptoms Stratified by Social Support

Variable	Low Social Support (n=929)^a		High Social Support (n=906)^b
	AOR (95% CI) ^c	p	AOR (95% CI) ^c	p
Perceived stress	1.236 (1.193–1.281)	< 0.001	1.198 (1.153–1.246)	< 0.001

Notes: ^aLow social support was defined as a SSRS score below the mean. ^bHigh social support was defined as a SSRS score above or equal to the mean. ^cAdjusted for maternal age, gestational age, education level, work status, household income per capita, marital status, exercise, and passive smoking.

Abbreviations: AOR, adjusted odds ratio; CI, confidence interval; SSRS, social support rating scale.