Relationships Between Family Functioning And Anxious And Depressive Symptoms In Women And Their Partners In The First And Second Trimester Of Pregnancy

Objective:The family is the main place for the physical and mental development of the individual.A dysfunctional family is associated with anxiety and depression.The incidence of anxious and depressive symptoms in women and their partners in the first and second trimester of pregnancy is common,which influences the physical and mental health of themselves negatively as well as their offspring.However,few studies have explored the correlations between family functioning and anxious and depressive symptoms in pregnant women and their partners in this period.Thus,the main objective of the current study was to investigate the relationships between family functioning and anxious and depressive symptoms in pregnant women and their partners in the first and second trimester of pregnancy,which may provide evidence for the targeted interventions.Methods:One hundred and fifty-two woman-partner pairs in the first trimester of pregnancy were enrolled at Changsha Hospital for Maternal&Child Health Care,Changsha,China.Among them,fifty-two pregnant women and twenty partners completed the 2-month follow-up after enrollment.Edinburgh Postnatal Depression Scale(EPDS),Patient Health Questionnaire(PHQ-9),and Generalized Anxiety Disorder-7(GAD-7)were applied to assess anxious and depressive symptoms.The Family Assessment Device(FAD)was chosen for the self-assessment of family functioning.Pregnant women with the total scores of EPDS≥10 points composed the group of pregnant women with depressive symptoms(PW-DS).Partners with the total scores of PHQ-9≥10 points composed the group of partners with depressive symptoms(PN-DS).Pregnant women with both the total scores of EPDS and GAD-7≤9 points composed the group of healthy pregnant women.Partners with both the total scores of PHQ-9 and GAD-7≤9 points composed the group of healthy partners.Subjects with the subscale scores of FAD higher than the cut-off scores composed the corresponding groups with dysfunctional FAD.On the contrary,they composed the corresponding groups with normal FAD.One-sample t-test was used to compare family functioning with the cut-off scores.Independent sample t-test,Mann-Whitney U test,and covariance analysis were applied to investigate differences in FAD and clinical symptoms between groups.Repeated measures analysis of variance and Friedman test were used to investigate characteristics of family functioning and clinical symptoms over time.Correlation analysis and univariate linear regression analysis were chosen to study the relationships between family functioning and mood symptoms.Results:(1)There were 19.7%of pregnant women and 12.5%of partners expressed significant depressive symptoms as well as 6.6%of women and 9.9%of partners with significant anxious symptoms in the first trimester of pregnancy.The PW-DS group was younger(t=2.435,P=0.016)and had shorter educational years(t=2.320,P=0.026)compared with the healthy women.The proportion of early pregnant reactions(χ~2=5.403,P=0.020)in the PW-DS group was higher than that of the healthy women.The proportions of history of drinking(χ~2=7.300,P=0.007)and smoking(χ~2=11.510,P=0.001)were higher in the group of PN-DS compared with the healthy partners.(2)Proportions of dysfunctional FAD-Behavior Control and Affective Involvement were highest in pregnant women and their partners both in the first trimester of pregnancy and the follow-up.In the first trimester,scores of FAD-Affective Involvement(P=0.016)and Behavior Control(P<0.001)in the group of PW-DS and scores of FAD-Behavior Control(P<0.001)in the group of PN-DS were higher than the cut-off scores.(3)In the pregnant women,total scores of EPDS in the groups of dysfunctional FAD-Problem Solving,Communication,Roles,Affective Responsiveness,Affective Involvement,and General Functioning,as well as total scores of GAD-7 in the groups of dysfunctional FAD-Problem Solving,Communication,Affective Involvement,and General Functioning were significantly higher than that of the normal groups both in the baseline and follow-up(P<0.05).(4)In partners,total scores of PHQ-9 in the groups of dysfunctional FAD-Problem Solving,Roles,and General Functioning,as well as total scores of GAD-7 in the groups of dysfunctional FAD-Problem Solving,Communication,Roles,and General Functioning were significantly higher than that of the normal groups(P<0.05)both in the baseline and follow-up.(5)Decreased scores of FAD-Roles,Affective Responsiveness,and General Functioning had significant independent positive predictive effects on decreased scores of EPDS in pregnant women(β=4.303,3.297,and 4.901;P<0.01),which could explain 13.5%,25.4%and 26.3%of the variance in decreased scores of EPDS respectively(R~2=0.135,0.254,and 0.263).(6)Decreased scores of FAD-Affective Responsiveness had a significant independent positive predictive effect on decreased scores of GAD-7 in pregnant women(β=2.436,P=0.006),which could explain 14.1%of the variance in decreased scores of GAD-7(R~2=0.141).(7)Decreased scores of FAD-Problem Solving,Communication,and General Functioning had significant independent positive predictive effects on decreased scores of GAD-7 in partners(β=4.173,3.153,and 4.554;P<0.05).The former two both can explain 22.0%of the variance in decreased scores of GAD-7(R~2=0.220),and the latter can explain 28.1%of the variance(R~2=0.281).Conclusion:Anxious and depressive symptoms were relatively common in women and partners in the first trimester of pregnancy.Family functioning of Behavior Control was significantly damaged both in pregnant women and partners with depressive symptoms.Dysfunctional FAD-Behavior Control and Affective Involvement were most prominent in women and partners in the first and second trimesters.Improvements in family functioning of Roles,Affective Responsiveness,and General Functioning could predict reductions in depressive symptoms in pregnant women.Improvements in family functioning of Affective Responsiveness could predict reductions in anxious symptoms in pregnant women.Improvements in family functioning of Problem Solving,Communication,and General Functioning could predict reductions in anxious symptoms in partners.Clinical attention should be paid to screening for mood symptoms in women and partners with dysfunctional family functioning above.The current study also provided a theoretical basis for the interventions based on family function for mood symptoms in pregnant women and partners in this period.