The effects of pregnancy discrimination on postpartum depressive symptoms: a follow-up study.
The effects of pregnancy discrimination on postpartum depressive symptoms: a follow-up study.
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DOI：
10.1186/s12884-022-05148-2
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发表时间：
2022-11-08
影响因子：
3.1
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中科院分区：
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工作场所的怀孕歧视在世界各地都很普遍。然而，很少有研究探讨怀孕歧视对母亲围产期心理健康的影响。本研究旨在探讨妊娠歧视与产后抑郁症状之间的关系，以及产前抑郁症状在这一关系中的中介作用。我们的样本包括285名在怀孕期间受雇的日本女性，她们于2020年5月完成了基线在线调查，并在产后两个月完成了后续邮件调查。怀孕歧视被定义为国家准则所禁止的与怀孕有关的16种不利待遇或骚扰中的任何一种。使用爱丁堡产后抑郁量表测量产前（基线评估）和产后（随访评估）抑郁症状。总体上进行了多元线性回归和中介分析，并按正式（永久）和非正式（不稳定）雇员分层。总体而言，23.9%的参与者在怀孕期间经历过怀孕歧视。校正潜在混杂因素后，妊娠歧视与产后抑郁症状显著相关（系数1.76，95%置信区间[CI] 0.65-2.88）。当按就业类型分层时，这些影响在非正式员工中可观察到（系数2.51，95% CI 0.45-4.57），但在正式员工中不可观察到。中介分析显示，产前抑郁症状介导了57.1%（95%CI 20.1-94.1%）的妊娠歧视和产后抑郁症状之间的关联，在非正式员工中的影响更大（64.1% [95%CI 18.5-109.8%]）。怀孕歧视对产后抑郁症状有不利影响，部分是通过产前抑郁症状，特别是在非正式雇员中。为预防女工的围产期抑郁症，雇主应遵守立法，采取预防措施，防止怀孕歧视，同时考虑到弱势雇员。在线版本包含补充材料，可通过10.1186/s12884-022-05148-2获得。
Pregnancy discrimination in the workplace is prevalent worldwide. However, few studies have examined the effects of pregnancy discrimination on mothers’ perinatal mental health. We aimed to investigate the association between pregnancy discrimination and postpartum depressive symptoms, and the mediation effects of prenatal depressive symptoms on this association. Our sample consisted of 285 Japanese women employed during pregnancy who completed a baseline online survey in May 2020 and a follow-up mail survey two months postpartum. Pregnancy discrimination was defined as exposure to any of 16 forms of disadvantageous treatment or harassment related to pregnancy, prohibited by national guidelines. Prenatal (assessed at baseline) and postpartum (assessed at follow-up) depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Multiple linear regression and mediation analyses were performed overall and stratified by regular (permanent) and non-regular (precarious) employees. Overall, 23.9% of participants experienced pregnancy discrimination during pregnancy. After adjusting for potential confounders, pregnancy discrimination was significantly associated with postpartum depressive symptoms (coefficient 1.76, 95% confidence interval [CI] 0.65–2.88). When stratified by employment type, these effects were observable among non-regular employees (coefficient 2.51, 95% CI 0.45–4.57) but not regular employees. Mediation analysis showed that prenatal depressive symptoms mediated 57.1% (95% CI 20.1–94.1%) of the association between pregnancy discrimination and postpartum depressive symptoms among all participants, with a greater effect among non-regular employees (64.1% [95% CI 18.5–109.8%]). Pregnancy discrimination has adverse effects on postpartum depressive symptoms, partially through prenatal depressive symptoms, especially among non-regular employees. To prevent perinatal depression in female workers, employers should comply with legislation and take preventive measures against pregnancy discrimination, while considering vulnerable employees. The online version contains supplementary material available at 10.1186/s12884-022-05148-2.
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