目的 调查产妇孕期身体意象、母婴依恋和产后抑郁的现状，探讨母婴依恋在产妇孕期身体意象与产后抑郁间的中介效应，以期为有效降低产后抑郁发生率和减轻抑郁症状提供参考和指导。 方法 采用便利抽样法选取2022年7—9月南京医科大学附属妇产医院（南京市妇幼保健院）产科住院孕妇362名，应用爱丁堡产后抑郁量表、孕妇身体意象量表和母婴依恋量表对其进行横断面调查。采用SPSS宏程序PROCESS中的模型4检验母婴依恋在产妇孕期身体意象和产后抑郁之间的中介作用。 结果 回收有效问卷362份，其中≤30岁194名，>30岁168名。孕期身体意象得分为（89.24 ± 15.56）分，母婴依恋得分为（71.40 ± 8.05）分，产后抑郁得分为7.50（4.00，11.00）分。产妇母婴依恋与孕期身体意象和产后抑郁均呈负相关（r= -0.368、-0.512，均P<0.01），孕期身体意象与产后抑郁呈正相关（r=0.402，P<0.01）。Bootstrap法检验结果显示，母婴依恋在产妇孕期身体意象和产后抑郁间的中介效应为0.056（95%CI 0.038～0.076），占总效应的43.08%。 结论 孕期身体意象不仅可以直接预测产后抑郁，还可通过母婴依恋的中介效应间接预测产后抑郁。护理人员应从积极心理学的角度开展以影响产后抑郁路径为依据的干预研究，从而达到预防或减少产妇产后抑郁发生的目的。 Objective To investigate the current status of maternal body image during pregnancy, mother-infant attachment and postpartum depression and explore the mediating effect of mother-infant attachment on maternal body image during pregnancy and postpartum depression, in order to effectively reduce the incidence of postpartum depression and provide reference and guidance for alleviating depressive symptoms. Methods A total of 362 pregnant women admitted to obstetric wards in Women′s Hospital of Nanjing Medical University were selected for a cross-sectional investigation by applying the Edinburgh Postnatal Depression Scale, the Body Image in Pregnancy Scale and the Maternal Postnatal Attachment Scale by convenient sampling from July to September 2022. Model 4 in the SPSS macro program PROCESS was used to test the mediating effect of maternal infant attachment between body image and postpartum depression. Results Totally 362 valid questionnaires were retrieved including 194 individuals aged ≤30 years old and 168 individuals aged >30 years old. The scores of maternal body image during pregnancy, mother-infant attachment and postpartum depression were (89.24 ± 15.56), (71.40 ± 8.05), 7.50 (4.00, 11.00) points. Mother-infant attachment was negatively correlated with body image during pregnancy and postpartum depression (r=-0.368, -0.512, both P<0.01), body image during pregnancy was positively correlated with postpartum depression (r=0.402, P<0.01). The results of Bootstrap test showed that the mediating effect of mother-infant attachment on the relationship between body image during pregnancy and postpartum depression was 0.056 (95%CI 0.038-0.076), accounting for 43.08% of the total effect. Conclusions Body image during pregnancy can not only directly predict postpartum depression, but also indirectly predict postpartum depression through the mediating effect of mother-infant attachment. In order to prevent or reduce the occurrence of postpartum depression, nursing staff should carry out intervention research based on influencing the path of postpartum depression from the perspective of positive psychology.
The mediating effect of mother-infant attachment on the relationship between maternal body image during pregnancy and postpartum depression
Objective To investigate the current status of maternal body image during pregnancy, mother-infant attachment and postpartum depression and explore the mediating effect of mother-infant attachment on maternal body image during pregnancy and postpartum depression, in order to effectively reduce the incidence of postpartum depression and provide reference and guidance for alleviating depressive symptoms. Methods A total of 362 pregnant women admitted to obstetric wards in Women′s Hospital of Nanjing Medical University were selected for a cross-sectional investigation by applying the Edinburgh Postnatal Depression Scale, the Body Image in Pregnancy Scale and the Maternal Postnatal Attachment Scale by convenient sampling from July to September 2022. Model 4 in the SPSS macro program PROCESS was used to test the mediating effect of maternal infant attachment between body image and postpartum depression. Results Totally 362 valid questionnaires were retrieved including 194 individuals aged ≤30 years old and 168 individuals aged >30 years old. The scores of maternal body image during pregnancy, mother-infant attachment and postpartum depression were (89.24 ± 15.56), (71.40 ± 8.05), 7.50 (4.00, 11.00) points. Mother-infant attachment was negatively correlated with body image during pregnancy and postpartum depression (r=-0.368, -0.512, both P<0.01), body image during pregnancy was positively correlated with postpartum depression (r=0.402, P<0.01). The results of Bootstrap test showed that the mediating effect of mother-infant attachment on the relationship between body image during pregnancy and postpartum depression was 0.056 (95%CI 0.038-0.076), accounting for 43.08% of the total effect. Conclusions Body image during pregnancy can not only directly predict postpartum depression, but also indirectly predict postpartum depression through the mediating effect of mother-infant attachment. In order to prevent or reduce the occurrence of postpartum depression, nursing staff should carry out intervention research based on influencing the path of postpartum depression from the perspective of positive psychology.
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