Psychosocial Work Demands and Major Depressive Symptoms among Working Pregnant Women

Abstract

Objective: Evaluate the association between psychosocial work demands and major depressive symptoms among working pregnant women.Methods: Karasek's abbreviated scale was used to measure psychosocial work demands (Job strain and "Iso-strain") and CES-D scale (Center for Epidemiological Studies Depression Scale) was used to measure major depressive symptoms (CES-D score ≥23) among 3765 working pregnant women interviewed at 24-26 weeks of pregnancy. Three series of logistic regression analyses were conducted to explore associations with: 1) the "demand-control" or "job strain" model; 2) the "demand-control-support" or "Iso-strain" models; 3) the three Karasek stress dimensions (job demand, job control and social support) forced individually into the same model. We examined the "buffer" hypothesis of "demand-control-support" model.Results: Prevalence of major depressive symptoms was 9.8% (95% CI: 8.7-10.8%). In all, 24.4% of pregnant working women were exposed to "high-strain" jobs (high demand and low control) and 17% to "Iso-strain" ("high-strain" job with low support at work). In bivariate and multivariate analyses, pregnant women who had "high-strain" or "Iso-strain" jobs were more likely to have major depressive symptoms. Psychosocial work demands were associated with the mental health of pregnant women, when other organizational and personal factors which they encountered outside the work settings were taken into account. The "buffer" hypothesis was refuted. Conclusion:Our study confirms accumulated findings related to Karasek and Theorell's "demandcontrol" and "demand-control-support" theoretical models. The impact of the "demand-control-support" model and the critical role of social support at work have been demonstrated among working pregnant women.