BMC public health · 2026
Perinatal trajectories of help-seeking stigma and correlates: a prospective cohort study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Tan, Wang Ying, Peng Jian, Yin Xiaoxv, Yan Qin, Fan Zina, Qiu Lei, Gong Yanhong
Аннотация
BACKGROUND: Help-seeking stigma (stigma of seeking professional psychological help) is a major barrier to perinatal mental health service use. However, longitudinal evidence on heterogeneous stigma trajectories and their baseline correlates remains limited.
METHODS: Pregnant women were recruited in the second trimester from four hospitals in two Chinese cities and completed stigma assessments at four time points (second trimester, third trimester, 1 month postpartum, and 3 months postpartum). Latent growth curve modelling assessed mean change and inter-individual variability. Growth mixture modelling identified latent trajectory classes. Baseline correlates of class membership were examined using R3STEP classification-adjusted multinomial logistic regression.
RESULTS: Of 1,250 enrolled women, 1,063 (85.0%) completed all assessments. Mean stigma remained stable, but significant heterogeneity was observed in both intercept and slope. Four trajectories were identified: low and decreasing (29.4%), moderate and stable (45.4%), high and increasing (18.3%), and moderate and rapidly increasing (6.9%). Compared with the moderate and stable class, elevated depressive symptoms at baseline (second trimester; EPDS ≥ 10) were associated with higher odds of the high and increasing class (adjusted odds ratio [aOR] = 2.46, 95% CI 1.63-3.71) and lower odds of the low and decreasing class (aOR = 0.50, 95% CI 0.30-0.84). More positive help-seeking attitudes and higher resilience were associated with lower odds of high and increasing and moderate and rapidly increasing trajectories. Unmarried/divorced status was associated with higher odds of the two increasing trajectories.
CONCLUSIONS: Mean-level stability in help-seeking stigma concealed clinically meaningful heterogeneity, with some women showing persistently moderate stigma and others following increasing trajectories over time. Baseline depressive symptoms, help-seeking attitudes, resilience, and marital status may support risk stratification within routine antenatal and early postpartum contacts, enabling targeted low-burden stigma-reduction and referral navigation to improve linkage to perinatal mental health care.
METHODS: Pregnant women were recruited in the second trimester from four hospitals in two Chinese cities and completed stigma assessments at four time points (second trimester, third trimester, 1 month postpartum, and 3 months postpartum). Latent growth curve modelling assessed mean change and inter-individual variability. Growth mixture modelling identified latent trajectory classes. Baseline correlates of class membership were examined using R3STEP classification-adjusted multinomial logistic regression.
RESULTS: Of 1,250 enrolled women, 1,063 (85.0%) completed all assessments. Mean stigma remained stable, but significant heterogeneity was observed in both intercept and slope. Four trajectories were identified: low and decreasing (29.4%), moderate and stable (45.4%), high and increasing (18.3%), and moderate and rapidly increasing (6.9%). Compared with the moderate and stable class, elevated depressive symptoms at baseline (second trimester; EPDS ≥ 10) were associated with higher odds of the high and increasing class (adjusted odds ratio [aOR] = 2.46, 95% CI 1.63-3.71) and lower odds of the low and decreasing class (aOR = 0.50, 95% CI 0.30-0.84). More positive help-seeking attitudes and higher resilience were associated with lower odds of high and increasing and moderate and rapidly increasing trajectories. Unmarried/divorced status was associated with higher odds of the two increasing trajectories.
CONCLUSIONS: Mean-level stability in help-seeking stigma concealed clinically meaningful heterogeneity, with some women showing persistently moderate stigma and others following increasing trajectories over time. Baseline depressive symptoms, help-seeking attitudes, resilience, and marital status may support risk stratification within routine antenatal and early postpartum contacts, enabling targeted low-burden stigma-reduction and referral navigation to improve linkage to perinatal mental health care.