The association between family support and maternal parenting stress: the potential mediating role of postpartum depressive symptoms

As a critical factor in early childhood development (ECD), parenting stress has been demonstrated to adversely affect maternal well-being and child developmental outcomes. This study examined the association between family support and maternal parenting stress and assessed whether postpartum depressive and anxiety symptoms account for this association. A cross-sectional survey was conducted among 1,099 mothers of children aged 0–2 years in Shanghai, China. The Simplified Chinese version of the Parenting Stress Index-Short Form (PSI-SF), the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale and the 21-item Depression Anxiety Stress Scales (DASS-21) were used to assess maternal parenting stress, family support and postpartum depressive and anxiety symptoms, respectively. Regression models were used to examine the study hypotheses and evaluate whether depressive and anxiety symptoms statistically explained the association. The mean parenting stress score was 26.37 ± 9.05. Overall, 24.3% of mothers reported low family support, 8.6% exhibited postpartum depressive symptoms, and 12.2% showed postpartum anxiety symptoms. Family support was negatively associated with maternal parenting stress ( β =−5.415, p < 0.001). After depressive and anxiety symptoms were entered into the model as candidate statistical mediators, depressive symptoms were significantly associated with maternal parenting stress ( β = 5.847, p < 0.001), whereas the association between family support and maternal parenting stress became non-significant ( β =−1.924, p > 0.05). There was no evidence of statistical mediation by anxiety symptoms. Lower family support was associated with higher maternal parenting stress, and depressive symptoms accounted for much of the association in the specified cross-sectional model. While these findings cannot establish temporality or causality, they support the prospective evaluation of family-centered care practices within the primary health care system.