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Social capital in pregnancy and postpartum depressive symptoms: a prospective mother-child cohort study (the Rhea study).

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kritsotakis, George Vassilaki, Maria Melaki, Vasiliki Georgiou, Vaggelis Philalithis, Anastassios E. Bitsios, Panos Kogevinas, Manolis Chatzi, Leda Koutis, Antonis
Spatial Coverage	Greece
Description	Country affiliation: Greece Author Affiliation: Kritsotakis G ( Department of Nursing, Technological Educational Institute of Crete, Greece. gkrits@staff.teicrete.gr)
Abstract	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: ß-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: ß-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.
File Format	HTM / HTML
ISSN	00207489
Issue Number	1
Volume Number	50
e-ISSN	1873491X
Journal	International Journal of Nursing Studies
Language	English
Publisher	Elsevier
Publisher Date	2013-01-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Nursing Depression, Postpartum Prevention & Control Pregnancy Psychology Social Environment Social Support Adult Epidemiology Female Greece Humans Linear Models Multivariate Analysis Prospective Studies Risk Factors Journal Article Multicenter Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Nursing

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