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Background <p>Antenatal depression (AND) is a common complication during pregnancy, particularly in rural China, where access to mental health resources is limited. This study aimed to examine the relationship between positive psychological capital (PsyCap) and AND, and to explore the mediating roles of maternal health literacy (MHL) and social support (SS).</p> Methods <p>A cross-sectional survey was conducted among 1,683 pregnant women from seven rural regions in China. Participants completed validated instruments measuring PsyCap, SS, MHL, and AND. Data were analyzed using Pearson correlations, hierarchical regression, and structural equation modeling. Mediation effects were tested with 5,000 samples bootstrapping.</p> Results <p>A total of 51.1% of participants screened positive for AND (M = 9.91). Positive psychological capital was significantly associated with lower depression scores (<i>β</i> = -0.32, <i>p</i> &lt; .01). Maternal health literacy (<i>β</i> = -0.13, <i>p</i> &lt; .01) and social support (<i>β</i> = -0.22, <i>p</i> &lt; .01) each partially mediated this relationship. Additionally, a mediation model suggested that higher PsyCap was associated with higher MHL and greater SS, and associated with lower depressive symptoms. The final model explained 28.0% of the variance in depression scores.</p> Conclusions <p>Positive psychological capital is negatively associated with antenatal depression, and this association is partially explained by higher maternal health literacy and social support. These findings highlight the potential importance of focusing on internal psychological resources, maternal health literacy, and social support in rural maternal mental health research. The results suggest that future interventions for AND in rural areas could explore community-based and digital approaches to improve maternal health literacy and social support.</p> Trial registration <p>The study was conducted according to the guidelines of the Declaration of Helsinki and was reviewed and approved by the Ethics Committees of Wuhan University (No. WHU-LFMD-IRB2023069) and Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai ([2023] 2023ZH0092).</p>

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Positive psychological capital and antenatal depression: the chain-mediating roles of social support and maternal health literacy in rural China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Shi-Yun Wang,
  • Dan Luo,
  • Yi-Qi Lai,
  • Xing Huang,
  • Rong Wang,
  • Chao-Yue Zhai,
  • Wei-Cai Zeng,
  • Yan-Qiong Ouyang

摘要

Background

Antenatal depression (AND) is a common complication during pregnancy, particularly in rural China, where access to mental health resources is limited. This study aimed to examine the relationship between positive psychological capital (PsyCap) and AND, and to explore the mediating roles of maternal health literacy (MHL) and social support (SS).

Methods

A cross-sectional survey was conducted among 1,683 pregnant women from seven rural regions in China. Participants completed validated instruments measuring PsyCap, SS, MHL, and AND. Data were analyzed using Pearson correlations, hierarchical regression, and structural equation modeling. Mediation effects were tested with 5,000 samples bootstrapping.

Results

A total of 51.1% of participants screened positive for AND (M = 9.91). Positive psychological capital was significantly associated with lower depression scores (β = -0.32, p < .01). Maternal health literacy (β = -0.13, p < .01) and social support (β = -0.22, p < .01) each partially mediated this relationship. Additionally, a mediation model suggested that higher PsyCap was associated with higher MHL and greater SS, and associated with lower depressive symptoms. The final model explained 28.0% of the variance in depression scores.

Conclusions

Positive psychological capital is negatively associated with antenatal depression, and this association is partially explained by higher maternal health literacy and social support. These findings highlight the potential importance of focusing on internal psychological resources, maternal health literacy, and social support in rural maternal mental health research. The results suggest that future interventions for AND in rural areas could explore community-based and digital approaches to improve maternal health literacy and social support.

Trial registration

The study was conducted according to the guidelines of the Declaration of Helsinki and was reviewed and approved by the Ethics Committees of Wuhan University (No. WHU-LFMD-IRB2023069) and Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai ([2023] 2023ZH0092).