The role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding: a longitudinal mediation analysis

作者：Li Liu, Shuya Feng, Yu Zhang, Gui Xiao, Mengjia Zhou, Xingxing Li, Ying Li, Chunxiang Qin · 发表于：BMC Pregnancy and Childbirth · 年份：2025 · DOI：10.1186/s12884-025-07481-8 · 被引用次数：8 · 研究领域：Breastfeeding Practices and Influences、Maternal Mental Health During Pregnancy and Postpartum、Gestational Diabetes Research and Management

BACKGROUND: Perinatal depressive symptoms are associated with exclusive breastfeeding; however, the longitudinal mediating process of this relationship remains unclear. Breastfeeding self-efficacy may be an important variable in understanding the complex process involved in their co-occurrence. Therefore, we aimed to explore the role of breastfeeding self-efficacy in the relationship between perinatal depressive symptoms and exclusive breastfeeding using both between- and within-person approaches. METHODS: A prospective longitudinal study was conducted from October 2021 to January 2024 at a tertiary hospital in Hunan, China. Depressive symptoms were measured at 36 gestational weeks and 1 week, 6 weeks, 3 months, and 6 months postpartum. Exclusive breastfeeding and breastfeeding self-efficacy were evaluated at the same postpartum intervals. Cross-lagged panel models, random intercepts cross-lagged panel models, and longitudinal mediation models were used to analyze their relationships. RESULTS: A total of 334 participants were included. Longitudinal mediation models revealed that breastfeeding self-efficacy mediated the prospective negative effect of perinatal depressive symptoms on exclusive breastfeeding at the between-person level (b = - 0.017, SE = 0.008, 95% CI (- 0.032, - 0.001), P = 0.036), and suppressed the positive effect of exclusive breastfeeding on depressive symptoms at the within-person level (b = - 0.044, SE = 0.022, 95% CI (- 0.087, 0.000), P = 0.047). CONCLUS...