Relation between mental health status and psychosocial stressors among pregnant and puerperium women in Japan - From the perspective of working status-

Background Mental health problems during pregnancy and postpartum periods are one of the alarming health issues among women in Japan. Many studies have reported that psychosocial risk factors could be correlated with maternal mental health status. Although increased numbers of women who are employed during the pregnancy and postpartum periods have been observed, it is unclear about the link between mental health and psychosocial stressors in terms of working status during pregnancy and postpartum periods. Therefore, this study examined difference in mental health status and the association between mental health and psychosocial stressors by working status amongpregnant and puerperium women, using nationally representative data in Japan. Methods This study analyzed data on the Japanese version of the Kessler 6 (K6), specific psychosocial stressors, and working status of pregnant and puerperium women (n=1126) from respondents in the Comprehensive Survey of People’s Living Conditions (CSPLC) conducted in 2007 by Ministry of Health, Labour and Welfare in Japan.. The univariate logistic regression analysis and a forward multiple regression analysis were used to examine K6 and related factors including specific psychosocial stressors for working status (‘employed’and ‘unemployed’). Results Those who scored five or higher in K6 accounted for 33.2% of 1126 respondents, and mental health had no significant association with working status among pregnant and puerperium women. Multiple logistic analyses showed the significant associations between mental health and psychosocial stressors: “family relationship,” “pregnancy and birth,” and“incomes/ family budgets/ debts”,regardless of “employed” or “unemployed”. After stratified by working status, whereas “one’s job” stressor had an association with mental health only for employed females, stressors for“one’s disease/long -term care” and “housework” had associations only for unemployed ones. For employed women, the primary factor for mental health was“family relationship” stressor. Conclusion Although mental health status measured by K6 was not different between employed or unemployed female population, primary stressors related mental health was revealed to differ with working status. Especially, “family relationship” stressor was the highest risk factor of mental health in employed women. More importantly, the results provided evidence on the differences in associations between mental health and specific psychosocial stressors by working status. Psychosocial risk assessments and interventions on working status among