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Objective <p>This study aims to examine the relationships among premenstrual syndrome (PMS), fear of childbirth (FOC), and postpartum depression (PPD) in postpartum women, and to test whether FOC mediates the association between PMS and PPD.</p> Methods <p>This multicenter cross-sectional study uses convenience sampling to recruit 815 postpartum women attending their 42-day postpartum check-up at Affiliated Hospital of Nantong University, Nantong First People’s Hospital, and Nantong Maternal and Child Health Hospital from November 2023 to July 2024. Data are collected using a general information questionnaire, Premenstrual Syndrome Scale, Wijma Delivery Experience Questionnaire, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, Dyadic Adjustment Scale, and Perceived Social Support Scale. Generalized linear models analyze factors influencing PPD. Correlation analysis, conducted using RStudio, examines relationships among PMS, FOC, and PPD. Multi-group structural equation modeling, with parity as the grouping variable, uses PMS as the independent variable, FOC as the mediator, and PPD as the dependent variable. The significance of the mediating effect is tested using the Bootstrap method.</p> Results <p>Generalized linear model analysis indicates that age at menarche, dysmenorrhea, planned pregnancy, feeding method, PMS, social support, sleep quality, and marital adjustment significantly predict PPD. Correlation analysis reveals positive correlations among PMS, FOC, and PPD. Multi-group structural equation modelling yields satisfactory model fit indices for both the primiparous and multiparous groups. In the primiparous group, the mediating effect of FOC accounts for 31.03% of the total effect, while in the multiparous group, it accounts for 43.62%.</p> Conclusion <p>Based on psychological stress theory, this study suggests continuity of emotional vulnerability of reproductive system stress responses across the perinatal period in mental health. The findings highlight the preventive value of targeting PMS to mitigate PPD, offering new insights for developing psychological interventions based on menstrual cycle management. Comprehensive nursing interventions span the entire perinatal period, including pre-pregnancy psychological counseling to alleviate negative emotions, optimizing childbirth experiences to reduce fear, and enhancing postpartum social support to improve maternal mental health, thereby effectively preventing and alleviating PPD.</p>

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Fear of childbirth mediates the relationship between premenstrual syndrome and postpartum depression in Chinese postpartum women: a multicenter cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月21日

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  • Yanran Li,
  • Yi Lu,
  • Cheng Ji

摘要

Objective

This study aims to examine the relationships among premenstrual syndrome (PMS), fear of childbirth (FOC), and postpartum depression (PPD) in postpartum women, and to test whether FOC mediates the association between PMS and PPD.

Methods

This multicenter cross-sectional study uses convenience sampling to recruit 815 postpartum women attending their 42-day postpartum check-up at Affiliated Hospital of Nantong University, Nantong First People’s Hospital, and Nantong Maternal and Child Health Hospital from November 2023 to July 2024. Data are collected using a general information questionnaire, Premenstrual Syndrome Scale, Wijma Delivery Experience Questionnaire, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, Dyadic Adjustment Scale, and Perceived Social Support Scale. Generalized linear models analyze factors influencing PPD. Correlation analysis, conducted using RStudio, examines relationships among PMS, FOC, and PPD. Multi-group structural equation modeling, with parity as the grouping variable, uses PMS as the independent variable, FOC as the mediator, and PPD as the dependent variable. The significance of the mediating effect is tested using the Bootstrap method.

Results

Generalized linear model analysis indicates that age at menarche, dysmenorrhea, planned pregnancy, feeding method, PMS, social support, sleep quality, and marital adjustment significantly predict PPD. Correlation analysis reveals positive correlations among PMS, FOC, and PPD. Multi-group structural equation modelling yields satisfactory model fit indices for both the primiparous and multiparous groups. In the primiparous group, the mediating effect of FOC accounts for 31.03% of the total effect, while in the multiparous group, it accounts for 43.62%.

Conclusion

Based on psychological stress theory, this study suggests continuity of emotional vulnerability of reproductive system stress responses across the perinatal period in mental health. The findings highlight the preventive value of targeting PMS to mitigate PPD, offering new insights for developing psychological interventions based on menstrual cycle management. Comprehensive nursing interventions span the entire perinatal period, including pre-pregnancy psychological counseling to alleviate negative emotions, optimizing childbirth experiences to reduce fear, and enhancing postpartum social support to improve maternal mental health, thereby effectively preventing and alleviating PPD.