Influences on coping styles during pregnancy, and association with postpartum depression: a cohort study

Abstract Background Few studies have examined protective or risk factors for coping styles of pregnant women, and studies which focus on coping in different ethnic populations are needed. The aim of this study was to investigate the coping styles of pregnant women and identify possible factors associated with coping. We further explored the effect of coping styles during pregnancy on postpartum depression.Methods Convenience sampling was used to recruit pregnant women in two maternal and child health hospitals in Hunan province, China. Participants completed the Self-made Questionnaire, Coping Style Questionnaire (CSQ), Generalized Anxiety Disorder (GAD-7), Brief Resilience Scale (BRS), Rosenberg Self-esteem Scale (RSES), and Edinburgh Postnatal Depression Scale (EPDS) at 4 time points (gestational week 12 or earlier; week 21~24; week 31~32; and 6 weeks postpartum). Totally 615 women were included in this study. Linear Regression analyses were used respectively to identify the possible predictors for coping and its effect on postpartum depression.Results (1) The resilience were associated with both positive and negative coping while self-esteem only related to positive coping in the antenatal period; (2) Women with a higher educational level scored higher on both positive and negative coping in pregnancy; (3) Higher level of positive coping and lower level of negative coping in the antenatal period were associated with postpartum depression.Conclusions Women with low self-esteem and resilience may have problems in coping in pregnancy and it would be necessary to identify women antenatally with these factors and help them deal with stressors during pregnancy better. Women with a higher level of education were more likely to use both positive and negative coping, which implied integration of different coping could be further explored in future research. Postpartum depression was associated with both positive and negative coping, indicating that coping intervention could be targeted for women with coping issues to prevent postpartum depression for care providers.