{"title":"母乳喂养自我效能感在围产期抑郁症状与纯母乳喂养关系中的作用：纵向中介分析","authors":"Li Liu, Shuya Feng, Yu Zhang, Gui Xiao, Mengjia Zhou, Xingxing Li, Ying Li, Chunxiang Qin","doi":"10.1186/s12884-025-07481-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Perinatal depressive symptoms are associated with exclusive breastfeeding; however, the longitudinal mediating process of this relationship remains unclear. Breastfeeding self-efficacy may be an important variable in understanding the complex process involved in their co-occurrence. Therefore, we aimed to explore the role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding using both between- and within-person approaches.</p><p><strong>Methods: </strong>A prospective longitudinal study was conducted from October 2021 to January 2024 at a tertiary hospital in Hunan, China. Depressive symptoms were measured at 36 gestational weeks and 1 week, 6 weeks, 3 months, and 6 months postpartum. Exclusive breastfeeding and breastfeeding self-efficacy were evaluated at the same postpartum intervals. Cross-lagged panel models, random intercepts cross-lagged panel models, and longitudinal mediation models were used to analyze their relationships.</p><p><strong>Results: </strong>A total of 334 participants were included. Longitudinal mediation models revealed that breastfeeding self-efficacy mediated the prospective negative effect of perinatal depressive symptoms on exclusive breastfeeding at the between-person level (b = - 0.017, SE = 0.008, 95% CI (- 0.032, - 0.001), P = 0.036), and suppressed the positive effect of exclusive breastfeeding on depressive symptoms at the within-person level (b = - 0.044, SE = 0.022, 95% CI (- 0.087, 0.000), P = 0.047).</p><p><strong>Conclusions: </strong>Mothers with perinatal depressive symptoms may face challenges in exclusive breastfeeding due to reduced breastfeeding self-efficacy. While increasing exclusive breastfeeding might help reduce depressive symptoms over time, this positive effect can be hindered if breastfeeding self-efficacy remains low. Our findings highlight breastfeeding self-efficacy as a critical target for future interventions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"356"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948809/pdf/","citationCount":"0","resultStr":"{\"title\":\"The role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding: a longitudinal mediation analysis.\",\"authors\":\"Li Liu, Shuya Feng, Yu Zhang, Gui Xiao, Mengjia Zhou, Xingxing Li, Ying Li, Chunxiang Qin\",\"doi\":\"10.1186/s12884-025-07481-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Perinatal depressive symptoms are associated with exclusive breastfeeding; however, the longitudinal mediating process of this relationship remains unclear. Breastfeeding self-efficacy may be an important variable in understanding the complex process involved in their co-occurrence. Therefore, we aimed to explore the role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding using both between- and within-person approaches.</p><p><strong>Methods: </strong>A prospective longitudinal study was conducted from October 2021 to January 2024 at a tertiary hospital in Hunan, China. Depressive symptoms were measured at 36 gestational weeks and 1 week, 6 weeks, 3 months, and 6 months postpartum. Exclusive breastfeeding and breastfeeding self-efficacy were evaluated at the same postpartum intervals. Cross-lagged panel models, random intercepts cross-lagged panel models, and longitudinal mediation models were used to analyze their relationships.</p><p><strong>Results: </strong>A total of 334 participants were included. Longitudinal mediation models revealed that breastfeeding self-efficacy mediated the prospective negative effect of perinatal depressive symptoms on exclusive breastfeeding at the between-person level (b = - 0.017, SE = 0.008, 95% CI (- 0.032, - 0.001), P = 0.036), and suppressed the positive effect of exclusive breastfeeding on depressive symptoms at the within-person level (b = - 0.044, SE = 0.022, 95% CI (- 0.087, 0.000), P = 0.047).</p><p><strong>Conclusions: </strong>Mothers with perinatal depressive symptoms may face challenges in exclusive breastfeeding due to reduced breastfeeding self-efficacy. While increasing exclusive breastfeeding might help reduce depressive symptoms over time, this positive effect can be hindered if breastfeeding self-efficacy remains low. Our findings highlight breastfeeding self-efficacy as a critical target for future interventions.</p>\",\"PeriodicalId\":9033,\"journal\":{\"name\":\"BMC Pregnancy and Childbirth\",\"volume\":\"25 1\",\"pages\":\"356\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-03-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948809/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pregnancy and Childbirth\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12884-025-07481-8\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pregnancy and Childbirth","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12884-025-07481-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
The role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding: a longitudinal mediation analysis.
Background: Perinatal depressive symptoms are associated with exclusive breastfeeding; however, the longitudinal mediating process of this relationship remains unclear. Breastfeeding self-efficacy may be an important variable in understanding the complex process involved in their co-occurrence. Therefore, we aimed to explore the role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding using both between- and within-person approaches.
Methods: A prospective longitudinal study was conducted from October 2021 to January 2024 at a tertiary hospital in Hunan, China. Depressive symptoms were measured at 36 gestational weeks and 1 week, 6 weeks, 3 months, and 6 months postpartum. Exclusive breastfeeding and breastfeeding self-efficacy were evaluated at the same postpartum intervals. Cross-lagged panel models, random intercepts cross-lagged panel models, and longitudinal mediation models were used to analyze their relationships.
Results: A total of 334 participants were included. Longitudinal mediation models revealed that breastfeeding self-efficacy mediated the prospective negative effect of perinatal depressive symptoms on exclusive breastfeeding at the between-person level (b = - 0.017, SE = 0.008, 95% CI (- 0.032, - 0.001), P = 0.036), and suppressed the positive effect of exclusive breastfeeding on depressive symptoms at the within-person level (b = - 0.044, SE = 0.022, 95% CI (- 0.087, 0.000), P = 0.047).
Conclusions: Mothers with perinatal depressive symptoms may face challenges in exclusive breastfeeding due to reduced breastfeeding self-efficacy. While increasing exclusive breastfeeding might help reduce depressive symptoms over time, this positive effect can be hindered if breastfeeding self-efficacy remains low. Our findings highlight breastfeeding self-efficacy as a critical target for future interventions.
期刊介绍：
BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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