Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study.
Eunjoo Lee
PMID 39756474WHAT IT FOUND
Pregnant women with higher stress reported more antenatal depression.
Lower self-esteem was associated with both stress and depression, and stronger social support was associated with a weaker stress and depression link.
Key findings
01Pregnancy stress was positively associated with antenatal depression (r=.52, p<.001).
02Self-esteem was part of the stress and depression pathway: higher stress was associated with lower self-esteem (B=-.15, p<.001), lower self-esteem was associated with higher depression (B=-.31, p<.001), and the indirect effect through self-esteem was .05 (95% CI 0.02 to 0.08).
03The stress and depression link was weaker at higher social support (interaction B=-.01, p=.036; direct effect slope moved from B=.15 to .08 as support increased).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional survey, so it cannot show that stress caused depression, or that self-esteem or social support changed the risk. Participants were pregnant women recruited by convenience sampling from one hospital in Korea, and most were married (98.3%), so results may not generalize. All measures were self-report questionnaires collected at one time, which can inflate associations between variables. The paper applied no depression cutoff and the mean depression score was 6.51 on a 0 to 30 scale, so it describes symptom levels rather than diagnosed depression. Mean gestational age was 23.34 weeks, and the authors note this early timing may have preceded more pronounced effects. The authors note the stress and social support tools may be outdated.
Declared interests
The author declared no conflict of interest. The work was funded by a National Research Foundation of Korea grant (NRF-2019R1G1A1100123) from the Korean government (MSIT).
The easy way to misread this
Do not conclude that improving self-esteem or increasing social support will prevent antenatal depression. This was a cross-sectional survey, so it shows associations, not tested effects of an intervention.