Relationship between maternal and infant health literacy and prenatal depression:the mediating effect of pregnancy stress

Deng Guangxu; Feng Xinyi; Zhou Tao; Ren Li; Yang Hong; Zhang Ling

doi:10.11986/j.issn.1673-873X.2025.09.02

Abstract：Objective To explore the relationship between maternal and infant health literacy,prenatal depression,and preg-nancy stress,and to examine the mediating effect of pregnancy stress between maternal and infant health literacy and prena-tal depression,with the aim of providing a reference for the development of more precise clinical interventions.Methods A total of 446 pregnant women from the two wings region of Chongqing(Southeast Chongqing and Northeast Chongqing re-gions)were surveyed using a self-designed general information questionnaire,the Edinburgh Postnatal Depression Scale(EPDS),a maternal and infant health literacy assessment questionnaire,and a pregnancy stress scale.Structural equation modeling was established using Amos to verify the relationships among the three variables.Results Overall,32.29％(144/446)of the participants were identified with prenatal depression.Significant differences were found in the prenatal de-pression detection rate among different groups based on region,years of education,occupation,sleep status,participation in health insurance,self-reported health status,whether they were multiparous,active learning of maternal and infant knowl-edge,participation in antenatal courses,and abnormal prenatal check-ups(P＜0.05).The maternal and infant health litera-cy assessment questionnaire scores,pregnancy stress scale scores,and EPDS scores were 46.64±22.87,0.67(0.28,0.97),and 7.00(4.00,7.00),respectively.Spearman's correlation analysis showed that EPDS scores were significantly negatively correlated with maternal and infant health literacy and its dimensions(P＜0.05),and significantly positively cor-related with pregnancy stress and its dimensions(P＜0.05).Maternal and infant health literacy had a negative predictive effect on both prenatal depression and pregnancy stress(β=-0.344 and β=-0.310,all P＜0.01);pregnancy stress had a positive predictive effect on prenatal depression(β=0.384,P＜0.05).Maternal and infant health literacy also affected prenatal depression through pregnancy stress(β=-0.119,P＜0.05),indicating that pregnancy stress plays a mediating role between maternal and infant health literacy and prenatal depression,with the mediating effect accounting for 25.7％of the total effect.Conclusion The incidence of prenatal depression in pregnant women of these regions remains high.Mater-nal and infant health literacy not only directly affects prenatal depression but also indirectly influences it through pregnancy stress.Medical staff can reduce the occurrence of prenatal depression by improving maternal and infant health literacy and alleviating pregnancy stress,thereby promoting both the physical and psychological health of pregnant women.