Postpartum depression (PPD) is highly prevalent and plagues a significant proportion of parents. Postpartum depression also exerts various negative consequences on infant development and parent-infant relationships. Social support is identified as an important factor influencing many parental predictors, and may affect the development of PPD.
Objective:
This study aimed to investigate how perceived social support can indirectly influence PPD symptoms in parents at 6 months postpartum by influencing postpartum anxiety, parental satisfaction, and parental self-efficacy (PSE).
Methods:
A secondary analysis of data from a randomized controlled trial was used with a cross-sectional exploratory design. A total of 400 Singaporean parents (200 couples) were included, and structural equation modeling was used to analyze the relationships between PPD and potential predictors.
Results:
Findings revealed a less adequate fit between the hypothesized model and the data collected. Social support was found to be a significant predictor of postpartum anxiety, PSE, and parental satisfaction. Postpartum anxiety was a significant predictor of PPD, but PSE and parental satisfaction were not.
Conclusion:
This study provides an overview of how different parental predictors may be associated with PPD among Asian parents. Postpartum anxiety significantly predicted PPD, but social support had negative effects on postpartum anxiety, parenting satisfaction, and PSE. The findings provide further insight into how parents at risk of PPD can be identified and demonstrated how social support might negatively impact parental outcomes. More qualitative research with Asian parents is needed to further explain these findings and inform the development of future interventions.
SlomianJHonvoGEmontsPReginsterJYBruyèreO.Consequences of maternal postpartum depression: a systematic review of maternal and infant outcomes. Womens Health. (Lond). 2019;15:1745506519844044. doi: 10.1177/1745506519844044. Erratum in: Womens Health (Lond). 2019;15:1745506519854864.
2.
RaoW-WZhuX-MZongQ-Q, et al. Prevalence of prenatal and postpartum depression in fathers: a comprehensive meta-analysis of observational surveys. J Affect Dis. 2020;263:491-499.
3.
FieldT.Postnatal anxiety prevalence, predictors and effects on development: a narrative review. Infant Behav Dev. 2018;51:24-32.
4.
KochSDe PascalisLVivianFMeurer RennerAMurrayLArtecheA.Effects of male postpartum depression on father–infant interaction: the mediating role of face processing. Infant Ment Health J. 2019;40(2):263-276.
5.
HehS-S.Relationship between social support and postnatal depression. Kaohsiung J Med Sci. 2003;19(10):491-495.
6.
WangSYJiangXYJanWCChenCH.A comparative study of postnatal depression and its predictors in Taiwan and mainland China. Am J Obstet Gynecol. 2003;189(5):1407-1412.
7.
Leahy-WarrenPMcCarthyGCorcoranP.First-time mothers: social support, maternal parental self-efficacy and postnatal depression. J Clin Nurs. 2012;21(3-4):388-397.
8.
ReidKMTaylorMG.Social support, stress, and maternal postpartum depression: a comparison of supportive relationships. Soc Sci Res. 2015;54:246-262.
9.
DotyJLDworkinJ.Online social support for parents: a critical review. Marriage Fam Rev. 2014;50(2):174-198.
10.
XueWLHeHGChuaYJWangWShoreyS.Factors influencing first-time fathers’ involvement in their wives’ pregnancy and childbirth: a correlational study. Midwifery. 2018;62:20-28.
11.
HagaSMLynneASlinningKKraftP.A qualitative study of depressive symptoms and well-being among first-time mothers. Scand J Caring Sci. 2012;26(3):458-466.
12.
FokDArisIMHoJ, et al. A comparison of practices during the confinement period among Chinese, Malay, and Indian mothers in Singapore. Birth. 2016;43(3):247-254.
13.
ChenLWLowYLFokD, et al. Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study. Public Health Nutr. 2014;17(9):1930-1938.
14.
ZhengJSunKAiliSYangXGaoL.Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: a cross-sectional study. Midwifery. 2022;105:103233.
15.
JonesTLPrinzRJ.Potential roles of parental self-efficacy in parent and child adjustment: a review. Clin Psychol Rev. 2005;25(3):341-363.
16.
PintoTMFigueiredoBPinheiroLLCanárioC.Fathers’ parenting self-efficacy during the transition to parenthood. J Reprod Infant Psychol. 2016;34(4):343-355.
17.
AnsariNSShahJDennisCLShahPS.Risk factors for postpartum depressive symptoms among fathers: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2021;100(7):1186-1199.
18.
ÁlvarezMByrneSRodrigoMJ.Social support dimensions predict parental outcomes in a Spanish early intervention program for positive parenting. Child Youth Serv Rev. 2021;121:105823.
19.
AkaroğluG.Variables of parental role satisfaction: social support, spousal support, parental stress and life satisfaction. Am J Fam Ther. 2023;51:37-56.
20.
TeissedreFChabolH.Postnatal depression: a study of the predictive effects of postnatal anxiety. Ir J Psychol Med. 2003;20(4):111-114.
21.
DourHJWileyJFRoy-ByrneP, et al. Perceived social support mediates anxiety and depressive symptom changes following primary care intervention. Depress Anxiety. 2014;31(5):436-442.
22.
ParienteGWissotzky BroderOSheinerE, et al. Risk for probable post-partum depression among women during the COVID-19 pandemic. Arch Womens Ment Health. 2020;23(6):767-773.
23.
ShoreySYingLYobasP.Parenting outcomes and predictors of parenting satisfaction in the early postpartum period. West J Nurs Res. 2021;43(1):13-24.
24.
Da CostaDDanieliCAbrahamowiczM, et al. A prospective study of postnatal depressive symptoms and associated risk factors in first-time fathers. J Affect Disord. 2019;249:371-377.
25.
CoxJLHoldenJMSagovskyR.Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-786.
26.
McBrideHLWiensRMMcDonaldMJCoxDWChanEKH. The Edinburgh Postnatal Depression Scale (EPDS): a review of the reported validity evidence. In: ZumboBDChanEKH eds. Validity and Validation in Social, Behavioral, and Health Sciences. Springer; 2014:157-174.
27.
ShoreySCheeCYINgEDLauYDennisC-LChanYH.Evaluation of a technology-based peer-support intervention program for preventing postnatal depression (part 1): randomized controlled trial. J Med Internet Res. 2019;21(8):e12410.
28.
DennisCHodnettEKentonL, et al. Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial. BMJ. 2009;338:a3064.
29.
LevisBNegeriZSunYBenedettiAThombsBD.Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ. 2020;371:m4022.
30.
SpielbergerCGorsuchRLusheneRVaggPJacobsG.Manual for the State-Trait Anxiety Inventory (STAI). Consulting Psychologists Press; 1983.
31.
VitasariPWahabMNAHerawanTOthmanASinnaduraiSK.Re-test of State Trait Anxiety Inventory (STAI) among engineering students in Malaysia: reliability and validity tests. Procedia Soc Behav Sci. 2011;15:3843-3848.
32.
LeerkesEMCrockenbergSC.The impact of maternal characteristics and sensitivity on the concordance between maternal reports and laboratory observations of infant negative emotionality. Infancy. 2003;4(4):517-539.
33.
ShoreySWangWYangYYYobasP.Psychometric properties of the Parenting Efficacy Scale among parents during the postnatal period in Singapore. J Child Fam Stud. 2018;27(6):1786-1793.
34.
PridhamKFChangAS.What being the parent of a new baby is like: revision of an instrument. Res Nurs Health. 1989;12(5):323-329.
35.
SalonenAHPridhamKFBrownRLKaunonenM.Impact of an internet-based intervention on Finnish mothers’ perceptions of parenting satisfaction, infant centrality and depressive symptoms during the postpartum year. Midwifery. 2014;30(1):112-122.
36.
LeerkesEMBurneyRV.The development of parenting efficacy among new mothers and fathers. Infancy. 2007;12(1):45-67.
37.
IacobucciD.Structural equations modeling: fit Indices, sample size, and advanced topics. J Consum Psychol. 2010;20(1):90-98.
38.
LaiKGreenSB.The problem with having two watches: assessment of fit when RMSEA and CFI disagree. Multivariate Behav Res. 2016;51(2-3):220-239.
39.
Department of Statistics Singapore. Key household income trends, 2022. 2023. www.singstat.gov.sg
40.
JohanssonMBenderixYSvenssonI.Mothers’ and fathers’ lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-Being. 2020;15(1):1722564.
41.
ShoreySTanTCThilagamangai, et al. Perinatal support for couples during COVID-19: a descriptive qualitative study. J Clin Nurs. 2023;32(13-14):3528-3542.
42.
XueAOrosVLa Marca-GhaemmaghamiP, et al. New parents experienced lower parenting self-efficacy during the COVID-19 pandemic lockdown. Children. 2021;8(2):79.
43.
BrownSMDoomJRLechuga-PeñaSWatamuraSEKoppelsT.Stress and parenting during the global COVID-19 pandemic. Child Abuse Negl. 2020;110(pt 2):104699.
44.
OllivierRAstonDMPriceDS, et al. Mental health & parental concerns during COVID-19: the experiences of new mothers amidst social isolation. Midwifery. 2021;94:102902.
45.
Ministry of Social and Family Development. Family and Work Report. Insight Series Paper. Ministry of Social and Family Development; 2017.
46.
AbdollahiFLyeMSMd ZainAShariff GhazaliSZarghamiM.Postnatal depression and its associated factors in women from different cultures. Iran J Psychiatry Behav Sci. 2011;5(2):5-11.
47.
HolopainenAHakulinenT.New parents’ experiences of postpartum depression: a systematic review of qualitative evidence. JBI Evid Synth. 2019;17(9):1731-1769.
48.
WithersMKharazmiNLimE.Traditional beliefs and practices in pregnancy, childbirth and postpartum: a review of the evidence from Asian countries. Midwifery. 2018;56:158-170.
49.
TakegataMOhashiYLazarusAKitamuraT.Cross-national differences in psychosocial factors of perinatal depression: a systematic review of India and Japan. Healthcare. 2017;5(4):91.
50.
BatterhamPJChristensenHMackinnonAJ.Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach. BMC Psychiatry. 2009;9(1):75.
51.
HornPJWuyekLA.Anxiety disorders as a risk factor for subsequent depression. Int J Psychiatry Clin Pract. 2010;14(4):244-247.
52.
OsborneLMVoegtlineKStandevenLR, et al. High worry in pregnancy predicts postpartum depression. J Affect Disord. 2021;294:701-706.
53.
Leahy-WarrenPMcCarthyG.Maternal parental self-efficacy in the postpartum period. Midwifery. 2011;27(6):802-810.
54.
ChoiSYKimEJRyuEChangKOParkMN.Postpartum depression and parental self-efficacy: a comparison of Native Korean and Vietnamese immigrant mothers in Korea. J Transcult Nurs. 2012;23(2):181-187.
55.
GuintivanoJManuckTMeltzer-BrodyS.Predictors of postpartum depression: a comprehensive review of the last decade of evidence. Clin Obstet Gynecol. 2018;61(3):591-603.
56.
YaksiNDilsadS.How do social and spousal support influence postpartum depression?Marmara Med J. 2021;34(3):327-338.
