TY - JOUR
TI - Social capital in pregnancy and postpartum depressive symptoms: A
prospective mother-child cohort study (the Rhea study)
AU - Kritsotakis, George
AU - Vassilaki, Maria
AU - Melaki, Vasiliki and
AU - Georgiou, Vaggelis
AU - Philalithis, Anastassios E.
AU - Bitsios, Panos
AU - and Kogevinas, Manolis
AU - Chatzi, Leda
AU - Koutis, Antonis
JO - International Journal of Nursing Studies
PY - 2013
VL - 50
TODO - 1
SP - 63-72
PB - PERGAMON-ELSEVIER SCIENCE LTD
SN - 0020-7489
TODO - 10.1016/j.ijnurstu.2012.08.012
TODO - EPDS; Depression; Depressive symptoms; Greece; Postpartum depression;
Social capital
TODO - Background: Depression, and to a lesser extent postpartum depressive
symptoms, have been associated with characteristics of the social
environment and social capital. Up to the present, mostly
cross-sectional studies have explored such an association without
providing a clear temporal relationship between social capital and
depression.
Objectives: To estimate prospectively the effect of individual-level
self-reported maternal social capital during pregnancy on postpartum
depressive symptoms.
Design: Prospective mother-child cohort (Rhea study).
Settings: 4 prenatal clinics in Heraklion, Crete, Greece.
Participants: All women for one year beginning in February 2007. From
the 1388 participants, complete data were available for 356 women.
Methods: Women self-completed two questionnaires: The Social Capital
Questionnaire at about the 24th week of gestation and the Edinburgh
Postnatal Depression Scale (range 0-30) at about the 8-10th week
postpartum. Maternal social capital scores were categorized into three
groups: the upper 10% was the high social capital group, the middle
80% was the medium and the lowest 10% was the low social capital group
that served as the reference category. Multivariable log-binomial and
linear regression models were performed for: the whole available sample;
for participants with a history of depression and/or prenatal EPDS >=
13; for participants without any previous or current depression and
prenatal EPDS score < 13. Potential confounders included demographic,
socio-economic, lifestyle and pregnancy characteristics that have an
established or potential association with maternal social capital in
pregnancy or postpartum depressive symptoms or both.
Results: Higher maternal social capital was associated with lower EPDS
scores (highest vs lowest group: beta-coefficient = -3.95, 95% CI
-7.75, -0.14). Similar effects were noted for the subscale value of
life/social agency (highest vs lowest group: beta-coefficient = -5.96,
95% CI -9.52, -2.37). This association remained significant for women
with and without past and/or present depression only for the subscale
value of life/social agency although with a more imprecise estimate. No
effect was found for participation, a structural dimension of social
capital.
Conclusions: Women with higher individual-level social capital in
mid-pregnancy reported less depressive symptoms 6-8 weeks postpartum.
Given the proposed association of perceptions of the social environment
with postpartum depressive symptoms, health professionals should
consider evidence-based interventions to address depression in a social
framework. (C) 2012 Elsevier Ltd. All rights reserved.
ER -