@2024 Afarand., IRAN

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ISSN: 2251-8215    Sarem Journal of Reproductive Medicine 2017;1(4):153-157

Background
Pregnancy Depression is a common disease [1]. Women are prone to depression more than their ‎postpartum period [2].‎
Previous Studies
‎... [3-20]. Psychosocial risk factors such as weakness or lack of social support, life stress, psychiatric ‎diseases, and the history of abuse and abuse in childhood and weakness in self-esteem [21] during ‎pregnancy increase the risk of postpartum depression. The reason for the importance of psychosocial ‎variables is due to their decreasing effect on stress because pregnancy is a period of change. 90% of ‎pregnant women suffer from moderate stress, with half of these stresses associated with physical ‎symptoms of pregnancy [22]. One of the factors that can have a stress-reducing effect and is strongly ‎linked to depression during pregnancy is social support, which is the amount of respect, affection, ‎love, and love one obtains from others [23]. Interactions and social conflicts can trigger depression. ‎For many adults, marriage is the most important social relationship [24]. The relationship between ‎marriage quality and depression is moderate. This correlation is -0.42 and -0.37 in women and men ‎respectively [25]. Research in China has shown that dissatisfaction with marriage, dissatisfaction with ‎family relationships, pregnancy depression and anxiety-related personality were the most important ‎predictors of postpartum depression [26]. Other research that has been conducted in eastern Asia on ‎the risk factors for pregnancy-induced depression has shown similar results in Western societies. ‎Lower age, smoking, less education, less education, unemployment, and in terms of psychological ‎factors, poor husband support and poor family support [27] are among these factors. A study in ‎Turkey showed that there is a correlation between the poor quality of communication with family ‎members in the third trimester of pregnancy and depression [28].‎ Hadizadeh et al. obtained a significant negative correlation between postpartum depression and the ‎quality of marital relationship [29]. Aghai et al. also reported on postpartum depression in their social ‎support and marital adjustment. 52% of variance in postpartum depression is explained by marital ‎adjustment and social support [30]. All of the researches have been related to postpartum depression ‎and less research has studied the relationship between social support and marital adjustment with ‎depression during pregnancy.‎
Aim(s)
The purpose of this study was to investigate the relationship between pregnancy depression and social ‎support and marital satisfaction.‎
Research type
This descriptive study is correlational.‎
Research society, place and time
This research was conducted during a six-month period among pregnant women referring to private ‎clinics in the last trimester of pregnancy in Karaj.‎
Sampling method and number
A total of 70 people were selected by convenience sampling method. Entry criteria included having at ‎least reading and writing literacy, first pregnancy or having no child, living with a spouse, and visiting ‎health centers. Exit criteria included physical illnesses, especially diabetes, or other high-risk ‎pregnancies and severe mental illnesses.‎
Used devices&materials
The following questionnaires were used as a research tool: Beck Depression Inventory (BDI-II): This questionnaire was developed by Beck in 1996. There are ‎‎21 items associated with different symptoms of depression that the subject is asked to rate the severity ‎of these symptoms based on a 4-point Likert scale of 0 to 3. This test is self-evaluation and scores ‎range from a minimum of zero to a maximum of 63, but only at a very high level of depression, the ‎score of 40 to 50 is obtained, and the score for depressed people typically ranges between 12 and 40. ‎Elvi and Cayenne have reported the internal validity of this questionnaire at 90%. In the Iranian ‎sample, the correlation coefficient of this questionnaire was re-tested and 0.73 weeks ago.‎ Social Support Appraisals Scale (SS-A): This questionnaire was developed by Wax et al. In 1994 and ‎contains 23 questions that cover three areas of family, friends and others. The scoring of this ‎questionnaire consists of four alternatives: "totally agree", "agree", "disagree", and "totally disagree”. ‎The minimum and maximum scores obtained from this test are 23 and 92 that four items i.e. 10, 13, 21 ‎and 22 are scored reversely. The reliability coefficient of this test was 0.9, and 0.7 in the sample of the ‎student in the whole scale and in the sample of the students respectively, and in the reprogramming in ‎the student population after the 6 weeks, the reliability was 0.81.‎ ENRICH Marital Satisfaction Inventory (ENRICH): This questionnaire has been used in several ‎studies to investigate marital satisfaction. The questionnaire is based on the 5-point Likert scale, with ‎‎115 questions and 12 scales. Items have 5 options. Due to the length of the questions, the short form ‎was extracted after that, and 47 questions were used in this study. The validity of this questionnaire ‎has been reported by Cronbach's alpha, 0.92. In the study by Mahdavian, the Pearson correlation ‎coefficient for retest in the interval of one week was 0.97 for men, and 0.99 for women. Correlation ‎coefficient of this questionnaire for family satisfaction scale was 0.41-0.60 and for life satisfaction ‎score it was 0.41 to 0.61.‎ Data analysis was performed by SPSS software. Correlation coefficient test was performed for the ‎relationship between depression with social support and marital satisfaction, and one way and ‎multiple analysis of variance (ANOVA) was performed to determine the degree of depression based on ‎the social support role and marital satisfaction.‎
Findings by Text
‎44.3 % of women were in the seventh month of pregnancy (Table 1). The mean depression score in ‎women was 12.74 ± 8.99. 91.4% of pregnancies were wanted. 2.85% had a history of laboring of dead ‎child. 12.85% had abortion history and 4.28 % had a history of infertility. Also, 11.4% had a history of ‎personal depression and 10% had family history of depression.‎There was a significant correlation between depression in pregnancy with social support (r = -0.368) ‎and marital satisfaction (r = -0.316). In other words, the greater the social support results in the lower ‎amount of depression and the greater the amount of marital satisfaction, results in decrease in the ‎amount of depression.‎ ‎15% of depression score during pregnancy is explained through social support and marital satisfaction ‎‎(F=6.051; P = 0.004) (R-Square = 0.153). Social support score had the most important role in the ‎prediction of depression during pregnancy. One standard deviation change in the social support score ‎led to a standard deviation of -0.278 in depression during pregnancy. While a variation in a standard ‎deviation of marital satisfaction score, only caused -0.16 change in the standard deviation of ‎depression during pregnancy (Table 2).‎
Main comparison to the similar studies
Pregnancy depression had a reverse and moderate correlation with social support (-0.368) and marital ‎satisfaction (-0.316). This finding was consistent with other studies in this area [25-29]. Stress is ‎fundamentally associated with psychological harm [31]. Since pregnancy is also a form of stress, it is ‎natural that it has a moderate correlation with depression. Existing research has shown that 50-80% of ‎depressed people, compared to 20% to 30% of non-depressed ones, experienced life-threatening ‎stresses up to 6 months before depression [31]. Some research samples during pregnancy have had ‎problems such as delivering death child, abortion or infertility, and this is a good basis for the ‎incidence or depression. As stress-related studies have shown, factors such as social support can affect ‎the relationship between depression and stress and reduce the amount of depression by reducing ‎stress. This finding was consistent with other studies conducted in the pregnant women population ‎‎[32, 33]. In Webster et al. research, women with lower social support were more likely to be prone to ‎depression during pregnancy and postpartum depression than those with more favorable social ‎support. Also, Sppozak et al. [33] have shown that a one or two unit increase in social support score is ‎consistent with a reduction of 58.3% and 82.6% respectively in the probability of depression.‎ Marital satisfaction was also negatively correlated with depression during pregnancy. As a result, the ‎higher the marital satisfaction of the pregnant person, the lower the probability of depression during ‎pregnancy. This finding was also in line with other studies conducted in the normal population. In this ‎way, there is a reverse correlation between the symptoms of pregnancy depression and satisfaction ‎with marital relationship. The finding was in line with other studies carried out in the pregnant ‎women's community [34-37].‎
Suggestions

Limitations
The present study, like any other study was faced with constraints such as selecting a city, examining ‎in the last quarter of gestation, and convenience sampling method.
Conclusions
Depression of pregnancy has a significant reverse correlation with social support and marital ‎satisfaction, and social support compared to marital satisfaction has a more important role in the ‎prediction of depression during pregnancy.
Acknowledgments

Conflict of interest

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Funding Sources

TABLES and CHARTS

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