Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study.

Abstract

Purpose: Social support and self-esteem play crucial roles in influencing the mental health of pregnant women. This study explored the moderating role of social support and the mediating role of self-esteem in the relationship between pregnancy-related stress and antenatal depression among pregnant women.

Methods: This cross-sectional study included 180 pregnant women who visited the obstetrics outpatient clinic at a hospital in Changwon, Korea, between November 22 and December 30, 2022. Data were collected through structured questionnaires that assessed antenatal depression, pregnancy stress, self-esteem, and social support. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and PROCESS Macro model 5.

Results: The mean gestational age of the participants was 23 weeks. The mean score for pregnancy stress was 63.51±14.33, indicating a moderate level of self-esteem and social support were high, with scores of 31.06±4.83 and 41.96±7.73, respectively. Prenatal depression was notably low, averaging 6.51±4.59. It showed a significant positive correlation with pregnancy stress (r=.52, p<.001) and negative correlations with self-esteem (r=-.49, p<.001) and social support (r=-.24, p=.001). Self-esteem acted as a mediator in the relationship between pregnancy stress and antepartum depression among pregnant women, with an indirect effect of .05 and a 95% confidence interval of .02 to .08. Additionally, social support moderated the impact of pregnancy stress on antepartum depression (B=-.01, p=.036).

Conclusion: The study emphasizes the need for a comprehensive approach to maternal mental health during pregnancy, which should include stress management, self-esteem enhancement, and social support interventions. Addressing these interconnected factors is crucial for promoting maternal well-being and reducing the incidence of prenatal depression.