Social support, religious commitment, and depressive symptoms in pregnant and postpartum women

Further Validation of the Religious Surrender and Attendance Scale-3 (RSAS-3)

Background: The Religious Surrender and Attendance Scale -3 (RSAS-3) is a very brief measure used to quantify religious commitment as a protective health factor.Methods: To provide evidence of criterion-related validity of the RSAS-3, 440 community members and undergraduate students completed a survey containing three religiosity measures: the RSAS-3, the Intrinsic/Extrinsic Orientation scale, and the Belief into Action scale (BIAC), and a measure of problematic substance use, Texas Christian University Drug Screen-5. It was hypothesized all religiosity measures would be positively interrelated, the measure of problematic use would be negatively related to all religiosity measures, and that the RSAS-3 would be strongly predictive of absence of problematic substance use. After data filtering and imputation, bivariate correlations were calculated to establish convergent validity.Results: All relationships were in the predicted directions. Specifically, BIAC had the strongest relationship with the RSAS-3, r (440) = .906, p < .001, followed by intrinsic religiosity, r (440) =.814, p < .001, and extrinsic religiosity, r (440) = .694, p < .001. The RSAS-3 was the strongest predictor of problematic use among the religiosity measures, r (440) = -0.230, p <.001. Criterion-related validity of the RSAS-3 was supported using logistic regression to explore intrinsic religiosity, extrinsic religiosity, BIAC, and RSAS-3 as predictors of the presence/absence of problematic substance use. The RSAS-3 was the only significant predictor (OR = .858 [95% CI .757 - .973], p = .017).Conclusion: All results provide further evidence for the validity of the RSAS-3 as a very brief measure of religious commitment useful in health settings.

Social support moderates the relation between childhood trauma and prenatal depressive symptoms in adolescent mothers

BACKGROUND

Depression is a concern during pregnancy, but it is especially prevalent for pregnant adolescents. Because prenatal depression is a strong predictor of postpartum depression and other forms of psychopathology in both mothers and children, it is important to understand potential risk and protective factors for prenatal depression.

OBJECTIVES

The present study examined whether social support buffered the impact of childhood trauma on prenatal depression, and whether social support exerted a stronger buffering effect for adolescents compared to adults.

METHOD

Self-reported levels of childhood trauma, social support, and prenatal depression were collected in a racially and ethnically diverse sample of 682 first-time mothers, 58% were adolescents (n = 396; Mage = 17.38 years) and 42% were adults (n = 286; Mage = 26.29 years).

RESULTS

Using multi-group moderation analyses, we found that pregnant adolescents with more social support were buffered from the effects of childhood trauma on prenatal depression symptoms, but pregnant adults with more social support were not.

CONCLUSION

Findings support the stress-buffering model in that those with more stressors may benefit more from social support than those with fewer stressors. These results highlight the importance of social support and inform prenatal depression prevention/intervention strategies particularly with pregnant adolescents.

Do taegyo practices, self-esteem, and social support affect maternal-fetal attachment in high-risk pregnant women? A cross-sectional survey

PURPOSE

The incidence of high-risk pregnancies is increasing in Korea as the birth age increasesdue to late marriage. Maternal-fetal attachment is an important factor that affects children even afterchildbirth, but it is difficult for high-risk pregnant women to form maternal-fetal attachment. Thecurrent study aimed to explore whether taegyo practice (i.e., pregnant women's efforts for fetal goodgrowth and development), self-esteem, and social support influenced the degree of maternal-fetalattachment in women with high-risk pregnancies.

METHODS

The participants included 226 pregnant Korean women at ≥20 gestational weeks, hospitalized with 15 high-risk pregnancy conditions as defined by the Ministry of Health and Welfare.Recruitment via convenience sampling was done at four sites in Busan, Korea. Surveys were distributed and collected from February 1 to 28, 2022. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchicalmultiple regression.

RESULTS

On average, participants were 33.97±4.23 years of age and at 31.65±6.23 gestational weeks.Preterm labor (35.4%) and gestational diabetes (21.0%) were the most common high-risk conditions. Maternal-fetal attachment was positively correlated with taegyo practice (r=.70, p<.001),self-esteem (r=.53, p<.001), and social support (r=.53, p<.001), all with statistical significance. Taegyo practice (β=.50, p<.001) and social support (β=.17, p=.030) explained 53% of variance in maternal-fetal attachment in women with high-risk pregnancies.

CONCLUSION

Nurses caring for women with high-risk pregnancies during hospitalization can usethese findings by promoting taegyo practice and enhancing social support to increase maternal-fetalattachment.

The Effect of Religious Attitudes on Anxiety and Psychological Well-being in Risky Pregnancies: A Cross-Sectional Study from Turkey

The aim of this study was to determine how religious attitudes of risky pregnant women affect their anxiety and psychological well-being. This is a cross-sectional study. It was carried out on 137 women diagnosed with risky pregnancy between December 2021 and February 2022 in a state hospital in Osmaniye, located in the southern Turkey. The findings of the study revealed that the participants' religious attitudes affected their trait anxiety and psychological well-being. Being religious in fact, boosted psychological well-being of the participants and lowered their trait anxiety level. They had a moderate religious attitude and a moderate psychological well-being but they also suffered from high trait anxiety levels.

A Qualitative Study of Religion and Spirituality in a Perinatal Psychiatry Inpatient Unit in the Southeast USA

Religion and spirituality are important aspects of culture that can interact with mental health. They can also be central components of women's experiences during pregnancy and the postpartum period. This study aims to explore the role of religion and spirituality among women experiencing severe psychopathology during the perinatal period using qualitative interviews of women hospitalized during pregnancy or postpartum on an inpatient unit in the Southeast USA. The average age of participants was 34.2 and all identified as white, aside from one who identified as other. Though religious affiliation was varied, most participants were Christian. Each patient interviewed had a diagnosis of depressive disorder, among other comorbid diagnoses. Three main themes emerged in the subsequent analyses (1) spirituality providing a sense of healing and connectedness above and beyond religion, (2) patients seeking support from religious leaders, and (3) patients experiencing familial pressure to enact religion in a certain way, especially as it relates to child rearing. Clinical implications for each of the themes are explored.

Does pain after delivery unequivocally lead to postpartum depression? The moderating role of religious coping

OBJECTIVE

The objective of this work is to explore whether the relationship between pain after delivery and postpartum depression is increased or decreased by the use of religion as a coping strategy (moderation).

METHODS

A longitudinal cohort study was conducted. The sample was evaluated on three occasions: third trimester of pregnancy (religious coping), after birth (pain severity) and four months after delivery (postpartum depression). Participants were 122 women (mean age = 31.29; SD = 4.9: range = [22, 42 years]) with low obstetric risk.

RESULTS

Both pain severity and religious coping contributed to postpartum depression (r = .20, p = .029 and r = .28, p = .04, respectively). Religious coping exacerbated the relationship between pain after delivery and postpartum depression (B = -0.11, t = -2.48, p = .014, [-0.20, -0.02]). Depression was highest in participants using religious coping irrespective of pain severity levels.

CONCLUSION

These findings support the importance of person-environment interaction studies and provide new evidence on the deleterious role of religious coping in the well-being of women after childbirth.

The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis

Background

Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.

Methods

The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I² statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis.

Result

From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety.

Conclusion

Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12978-021-01209-5.

Pregnancy is a significant event for reproductive-age women. It is supplemented by hormonal changes and can represent a time of increased risk for the occurrence of mental illness like depression, anxiety and self-harm. Providing good social support for the pregnant mother reduce this risk and prevent pregnancy complication and adverse birth outcome. However, no systematic review and/or meta-analysis has explored the associations between social support and mental illness (depression, anxiety, self-harm) among pregnant women. Therefore, this systematic review and meta-analysis aimed to examine the association between social support and mental illness (anxiety, depression, and self-harm) during pregnancy.

The review identified 67 relevant articles with 64,449 pregnant women, from PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database. Of the total 67 articles, 22 articles included in the narrative review and 45 articles included in the meta-analysis. Among studies included in the narrative synthesis, a majority of them reported significant positive associations between low social support and antenatal depression, antenatal anxiety and self-harm during pregnancy. Further, the pooled estimates of the meta-analysis show that low social support had a significant positive association with antenatal depression (AOR: 1.18 (95% CI: 1.01, 1.41)) and antenatal anxiety (AOR: 1.97 (95% CI: 1.34, 2.92)). Therefore, maternal health professionals need to have discussions with pregnant women regarding the level and source of social support they receive. Maternal health professionals may also need to consider encouraging the social network of pregnant women to improve social support being given. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.

The relationship between psychosocial health status and social support of pregnant women

PURPOSE

The aim of this study was to determine the relationship between psychosocial health status and social support, which has important effects on pregnancy, and to determine the factors related to both psychosocial health and social support.

METHOD

The research was planned to be a descriptive study. The sample of the study consisted of 393 pregnant women. 'Personal Information Form', 'Pregnancy Psychosocial Health Assessment Scale (PPHAS)', and 'Multidimensional Scale of Perceived Social Support (MSPSS)' were used to collect data, and Student's t-test, ANOVA and Tukey's HSD tests were used for the data analysis. The relationship between the two continuous variables was evaluated according to the Pearson correlation coefficient.

RESULTS

Psychosocial health conditions and perceived social supports of pregnant women whose spouses were working were determined to be significantly higher (p < .05), and at a lower level (p < .05) in pregnant women with two or more children. As MSPSS total mean scores of the pregnant women increased, their PPHAS total mean scores were weakly affected in the positive direction (r = 0.393, p < .01).

CONCLUSIONS

It is recommended that health care needs of pregnant women should be evaluated not only in terms of physical health but also together with their psychosocial health and social supports. Furthermore, this assessment should be done in their own home environment with their spouses and other family members.

The Association of Religion and Spirituality with Postpartum Mental Health in Women with Childhood Maltreatment Histories

OBJECTIVES

Although the associations between religion and spirituality and mental health and trauma have been studied extensively across various populations, relatively few studies have focused on the postpartum period. This study aimed to shed light on specific domains of religiosity and spirituality that may be resiliency factors for positive postpartum adjustment defined as low depression and high quality of life in mothers oversampled for childhood trauma histories.

METHODS

We examined several religion and spirituality variables among 108 women at 6 months postpartum as well as prospective relations from religion and spirituality to postpartum depression and quality of life at 12 and 15 months postpartum.

RESULTS

We found that the personal aspects of self-forgiveness and forgiveness for others were most relevant as resiliency factors predicting lower postpartum depression and better quality of life even when controlling for other risks (trauma and demographics). Surprisingly, no other religion and spirituality domain had associations with postpartum depression or quality of life, with the exception of a significant negative association for organizational religiousness with quality of life at 12 months postpartum.

CONCLUSIONS

Our findings suggest that forgiveness, especially to self and to others, in women who have been physically and mentally hurt as children may be associated with mental wellness and quality of life in the late postpartum period. Further, our results point to the need to study specific religion and spirituality aspects in the context of specific populations and conditions instead of generally studying religion and spirituality as a common marker for coping.