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Factors Influencing Maternal Depression: Secondary Data Analysis
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Original Article

Factors Influencing Maternal Depression: Secondary Data Analysis

Korean Journal of Adult Nursing 2016;28(3):288-301.
Published online: June 30, 2016

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Corresponding author: Choi, Mi-Young Department of Nursing Science in the College of Medicine, Chungbuk National University, 1 Chung-daero, Seowon-gu, Cheongju 362-763, Korea. Tel: +82-43-249-1798, Fax: +82-43-266-1710, E-mail: myb98@chungbuk.ac.kr
• Received: April 4, 2016   • Accepted: June 22, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify association between maternal depression and multiple contextual factors in 1,519 mothers in Korea who participated in the 2009 Panel Study of Korean Children (PSKC).
  • Methods
    The second wave data which was a comprehensive longitudinal data set with a nationally representative birth cohort was analyzed using SAS 9.3 software. Kessler depression scale was used for this study.
  • Results
    Of the mothers, 23.0% reported being mild to moderate depression and 4.5% of the mothers reported severe depression. The factors influencing maternal depression include; mother's self-efficacy, mother's marital conflict, mother's social support, infant's and toddler's emotionality, mother's smoking and infant's feeding & eating of daily routine. These variables explained 39.5% of maternal depression.
  • Conclusion
    The results of this study suggest that the identified factors for maternal depression should be included in an intervention program to reduce the risk of depression.
Table 1.
Mothers' General Characteristics (N=1,519)
Variables Characteristics Categories n (%) M±SD
Mother Age (year) 20~29 349 (23.0) 32.17±3.64
30~39 1,132 (74.5)
≥40 38 (2.5)
Duration being married (months) <36 529 (34.8) 57.70±36.98
36~59 418 (27.5)
60~119 465 (30.6)
≥120 107 (7.1)
Educational level ≤High school 447 (29.4)
College & university 996 (65.6)
≥Master degree 76 (5.0)
Religion Yes 792 (52.1)
No 727 (47.9)
Marital status First marriage 1,501 (98.8)
Others 18 (1.2)
Job status Yes 477 (31.4)
No 1,042 (68.6)
Living with infant Yes 1,488 (98.0)
No 31 (2.0)
Living with infant's father Yes 1,458 (96.0)
No 61 (4.0)
Smoking Yes 23 (1.5)
No 1,496 (98.5)
Drinking Yes 535 (35.2)
No 984 (64.8)
Depression Normal 1,101 (72.5) 11.42±4.13
Mild & moderate depression 349 (23.0)
Severe depression 69 (4.5)
Father Age (year) 20~29 138 (9.1) 34.65±3.98
30~39 1,221 (80.4)
≥40 160 (10.5)
Education ≤High school 392 (25.8)
College & university 973 (64.1)
≥Master degree 154 (10.1)
Religion Yes 672 (44.2)
No 847 (55.8)
Job status Yes 1,494 (98.4)
No 25 (1.6)
Smoking Yes 799 (52.6)
No 720 (47.4)
Drinking Yes 1,195 (78.7)
No 324 (21.3)
Infant Gender Boy 763 (50.2)
Girl 756 (48.8)
Age (month) 11~12 97 (6.4) 14.05±1.06
13~15 1,305 (85.9)
16~18 117 (7.7)
Table 2.
Influencing Factors (N=1,519)
Variables   Categories n (%) or M±SD Range
Mother's independent variables Marital satisfaction   15.59±3.08 4~20
Marital conflict   16.16±6.04 8~39
Paternal participation in child rearing   14.55±3.51 4~20
Social support   46.48±7.64 12~60
Self-efficacy   9.15±2.78 4~19
Self-esteem   30.07±4.09 14~40
Parenting stress   27.21±6.41 10~50
Child rearing: parental style   23.44±2.93 12~30
Knowledge of child rearing   9.12±2.12 0~13
Value of children Emotional value 12.99±1.73 3~15
Instrumental value 11.74±3.08 4~20
Father's independent characteristics  Marital satisfaction   16.99±3.31 4~20
Marital conflict   15.60±5.88 8~38
Value of children Emotional value 13.29±1.98 3~15
Instrumental value 13.19±3.35 4~20
Infant independent characteristics Temperament Emotionality 13.51±3.12 5~25
Activity 16.44±1.67 11~23
Developmental profiles-daily routines Sleep 8.17±2.20 3~15
Feeding & eating 11.27±2.76 4~19
Bowel/washing 11.00±2.92 4~20
Total 30.45±5.76 11~50
Korean-ages & stage Communication 49.52±11.24 5~60
Gross motor 56.63±8.75 0~60
Fine motor 47.63±11.92 0~60
Problem solving 49.54±11.95 0~60
Personal-social 52.85±10.75 0~60
Total    
 Number of below broken line 0~1 1,494 (98.0)  
 Number of below broken line≥2 25 (2.0)  
Denver developmental screening test II Normal development 1,146 (75.4)
Suspected development 373 (24.6)
Treatment due to accident/ poisoning Yes 237 (15.6)
No 1,282 (84.4)
Hospitalization in past Yes 317 (20.9)
No 1,202 (79.1)
Family's economic status Average monthly income (10,000 won)   333.98±215.22
National basic living security system state People on basic welfare 15 (1.0))
The second-to-the bottom income bracket 62 (4.1)
No 1,442 (94.9)
House One's own house/ leased house 1,372 (90.3)
Rental house/monthly rent house/others 147 (9.7)
Table 3.
Comparison of Maternal Depression Scores (N=1,519)
Variables Characteristics Categories Depression scores
n (%) M±SD t or F (p)
Mother's independent variables Age (year) 20~29 349 (23.0) 11.42±4.52 0.02
30~39 1,132 (74.5) 11.41±4.03 (.979)
≥40 38 (2.5) 11.55±3.66  
Duration being married <36 529 (34.8) 11.49±4.46 1.41
36~59 418 (27.5) 11.52±4.10 (.237)
60~119 465 (30.6) 11.43±3.91  
≥120 107 (7.1) 10.64±3.42  
Educational level ≤High school 447 (29.4) 12.08±4.74a 8.31
College & university 996 (65.6) 11.12±3.85b (<.001)
≥Master degree 76 (5.0) 10.92±3.39b a>b
Religion Yes 792 (52.1) 11.52±4.10 0.99
No 727 (47.9) 11.31±4.16 (.320)
Marital status First marriage 1,501 (98.8) 11.40±4.13 -1.87
Others 18 (1.2) 13.17±4.22 (.014)
Job status Yes 477 (31.4) 10.97±3.95 2.86
No 1,042 (68.6) 11.62±4.20 (.004)
Living with infant Yes 1,488 (98.0) 11.38±4.10 -1.87
No 31 (2.0) 13.19±5.42 (.014)
Living with infant's father Yes 1,458 (96.0) 11.41±4.11 -0.17
No 61 (4.0) 11.51±4.71 (.862)
Smoking Yes 23 (1.5) 15.61±5.84 3.48
No 1,496 (98.5) 11.35±4.07 (.002)
Drinking Yes 535 (35.2) 11.95±4.28 -3.71
No 984 (64.8) 11.13±4.02 (<.001)
Father's demographic characteristics  Age (year) 20~29 138 (9.1) 11.68±4.54 0.54
30~39 1,221 (80.4) 11.42±4.15 (.581)
≥40 160 (10.5) 11.18±3.60  
Educational level ≤High school 392 (25.8) 11.99±4.61a 8.79
College & university 973 (64.1) 11.35±3.98a (<.001)
≥Master degree 154 (10.1) 10.40±3.51b a>b
Religion Yes 672 (44.2) 11.18±3.98 -2.01
No 847 (55.8) 11.61±4.24 (.044)
Job status Yes 1,494 (98.4) 11.42±4.14 0.17
No 25 (1.6) 11.56±3.73 (.862)
Smoking Yes 799 (52.6) 11.77±4.38 3.57
No 720 (47.4) 11.02±3.81 (<.001)
Drinking Yes 1,195 (78.7) 11.54±4.15 2.30
No 324 (21.3) 10.95±4.05 (.021)
Infant's and toddler's characteristics Gender Boy 763 (50.2) 11.44±4.13 0.17
Girl 11~12 756 (48.8) 11.40±4.13 (.861)
Age (month) 11~12 97 (6.4) 12.33±4.08a 3.00
13~15 1,305 (85.9) 11.32±4.07b (.050)
16~18 117 (7.7) 11.71±4.75a,b a>b
Korean-age & stage Total
 Number of below broken line 0~1 1,494 (98.0) 11.37±4.10 -3.31
 Number of below broken line≥2 25 (2.0) 14.12±5.17 (.001)
DDST II Normal development 1,146 (75.4) 11.38±4.09 -0.59
Suspected development 373 (24.6) 11.53±4.27 (.553)
Treatment due to accident/poisoning Yes 237 (15.6) 11.69±3.95 1.09
No 1,282 (84.4) 11.37±4.17 (.274)
Hospitalization in past Yes 317 (20.9) 11.67±4.43 1.15
No 1,202 (79.1) 11.35±4.05 (.249)
Family's economic status The national basic living security system state People on basic welfare 15 (1.0) 11.20±4.96 0.85
Those in the second-to-the bottom income bracket 62 (4.1) 12.08±4.09 (.429)
No 1,442 (94.9) 11.39±4.13  
House One's own house/ leased house 1,372 (90.3) 11.33±4.08 -2.68
Rental house/monthly rent house/others 147 (9.7) 12.29±4.49 (.007)

a, b: Duncan grouping.

Table 4.
Correlation of Influencing Factors to Maternal Depression Scores (N=1,519)
Variables   Categories Depression scores
r(p)
Mother's independent variables Marital satisfaction   -.32 (<.001)
Marital conflict   .48 (<.001)
Paternal participation in child rearing   -.23 (<.001)
Social support   -.32 (<.001)
Self-efficacy   .54 (<.001)
Self-esteem   -.55 (<.001)
Parenting stress   .51 (<.001)
Child rearing: parental style   -.34 (<.001)
Knowledge of child rearing   -.08 (.001)
Value of children Emotional value -.26 (<.001)
Instrumental value -.12 (<.001)
Father's independent characteristics  Marital satisfaction   -.21 (<.001)
Marital conflict   .32 (<.001)
Value of children Emotional value -.09 (<.001)
Instrumental value -.04 (.141)
Infant's and toddler's independent characteristics Temperament survey Emotionality .27 (<.001)
Activity .01 (.681)
Developmental profiles-daily routines Sleep -.01 (.613)
Feeding & eating .05 (.033)
Bowel/washing -.04 (.166)
Total .00 (.920)
Korean-ages & stage Communication -.02 (.432)
Gross motor -.07 (.005)
Fine motor -.01 (.596)
Problem solving -.02 (.450)
Personal-social -.07 (.004)
Family's economic status Average monthly income (10,000 won)   -.13(<.001)
Table 5.
Factors Influencing on Mother's Depression (N=1,519)
Variables β SE Std. β t p Partial R2 Accum. R2
Intercept 3.90 0.81   4.80 <.001    
Mother's self-efficacy 0.52 0.04 0.34 14.99 <.001 .304 .304
Mother's marital conflict 0.17 0.02 0.25 10.53 <.001 .058 .362
Mother's social support -0.06 0.01 -0.12 -5.55 <.001 .014 .376
Infant's and toddler's emotionality 0.14 0.03 0.11 5.49 <.001 .012 .388
Mother's smoking (ref non-smoking) 2.26 0.77 0.07 2.93 .003 .004 .392
Infant's and toddler's feeding & eating of daily routine 0.08 0.03 0.05 2.82 .004 .003 .395
R2=.395, Adj. R2=.392, F=164.26, p<.001

Std. β=Standardized β; Accum. β=Accumulated R2.

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    Factors Influencing Maternal Depression: Secondary Data Analysis
    Korean J Adult Nurs. 2016;28(3):288-301.   Published online June 30, 2016
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    Factors Influencing Maternal Depression: Secondary Data Analysis
    Factors Influencing Maternal Depression: Secondary Data Analysis

    Mothers' General Characteristics (N=1,519)

    Variables Characteristics Categories n (%) M±SD
    Mother Age (year) 20~29 349 (23.0) 32.17±3.64
    30~39 1,132 (74.5)
    ≥40 38 (2.5)
    Duration being married (months) <36 529 (34.8) 57.70±36.98
    36~59 418 (27.5)
    60~119 465 (30.6)
    ≥120 107 (7.1)
    Educational level ≤High school 447 (29.4)
    College & university 996 (65.6)
    ≥Master degree 76 (5.0)
    Religion Yes 792 (52.1)
    No 727 (47.9)
    Marital status First marriage 1,501 (98.8)
    Others 18 (1.2)
    Job status Yes 477 (31.4)
    No 1,042 (68.6)
    Living with infant Yes 1,488 (98.0)
    No 31 (2.0)
    Living with infant's father Yes 1,458 (96.0)
    No 61 (4.0)
    Smoking Yes 23 (1.5)
    No 1,496 (98.5)
    Drinking Yes 535 (35.2)
    No 984 (64.8)
    Depression Normal 1,101 (72.5) 11.42±4.13
    Mild & moderate depression 349 (23.0)
    Severe depression 69 (4.5)
    Father Age (year) 20~29 138 (9.1) 34.65±3.98
    30~39 1,221 (80.4)
    ≥40 160 (10.5)
    Education ≤High school 392 (25.8)
    College & university 973 (64.1)
    ≥Master degree 154 (10.1)
    Religion Yes 672 (44.2)
    No 847 (55.8)
    Job status Yes 1,494 (98.4)
    No 25 (1.6)
    Smoking Yes 799 (52.6)
    No 720 (47.4)
    Drinking Yes 1,195 (78.7)
    No 324 (21.3)
    Infant Gender Boy 763 (50.2)
    Girl 756 (48.8)
    Age (month) 11~12 97 (6.4) 14.05±1.06
    13~15 1,305 (85.9)
    16~18 117 (7.7)

    Influencing Factors (N=1,519)

    Variables   Categories n (%) or M±SD Range
    Mother's independent variables Marital satisfaction   15.59±3.08 4~20
    Marital conflict   16.16±6.04 8~39
    Paternal participation in child rearing   14.55±3.51 4~20
    Social support   46.48±7.64 12~60
    Self-efficacy   9.15±2.78 4~19
    Self-esteem   30.07±4.09 14~40
    Parenting stress   27.21±6.41 10~50
    Child rearing: parental style   23.44±2.93 12~30
    Knowledge of child rearing   9.12±2.12 0~13
    Value of children Emotional value 12.99±1.73 3~15
    Instrumental value 11.74±3.08 4~20
    Father's independent characteristics  Marital satisfaction   16.99±3.31 4~20
    Marital conflict   15.60±5.88 8~38
    Value of children Emotional value 13.29±1.98 3~15
    Instrumental value 13.19±3.35 4~20
    Infant independent characteristics Temperament Emotionality 13.51±3.12 5~25
    Activity 16.44±1.67 11~23
    Developmental profiles-daily routines Sleep 8.17±2.20 3~15
    Feeding & eating 11.27±2.76 4~19
    Bowel/washing 11.00±2.92 4~20
    Total 30.45±5.76 11~50
    Korean-ages & stage Communication 49.52±11.24 5~60
    Gross motor 56.63±8.75 0~60
    Fine motor 47.63±11.92 0~60
    Problem solving 49.54±11.95 0~60
    Personal-social 52.85±10.75 0~60
    Total    
     Number of below broken line 0~1 1,494 (98.0)  
     Number of below broken line≥2 25 (2.0)  
    Denver developmental screening test II Normal development 1,146 (75.4)
    Suspected development 373 (24.6)
    Treatment due to accident/ poisoning Yes 237 (15.6)
    No 1,282 (84.4)
    Hospitalization in past Yes 317 (20.9)
    No 1,202 (79.1)
    Family's economic status Average monthly income (10,000 won)   333.98±215.22
    National basic living security system state People on basic welfare 15 (1.0))
    The second-to-the bottom income bracket 62 (4.1)
    No 1,442 (94.9)
    House One's own house/ leased house 1,372 (90.3)
    Rental house/monthly rent house/others 147 (9.7)

    Comparison of Maternal Depression Scores (N=1,519)

    Variables Characteristics Categories Depression scores
    n (%) M±SD t or F (p)
    Mother's independent variables Age (year) 20~29 349 (23.0) 11.42±4.52 0.02
    30~39 1,132 (74.5) 11.41±4.03 (.979)
    ≥40 38 (2.5) 11.55±3.66  
    Duration being married <36 529 (34.8) 11.49±4.46 1.41
    36~59 418 (27.5) 11.52±4.10 (.237)
    60~119 465 (30.6) 11.43±3.91  
    ≥120 107 (7.1) 10.64±3.42  
    Educational level ≤High school 447 (29.4) 12.08±4.74a 8.31
    College & university 996 (65.6) 11.12±3.85b (<.001)
    ≥Master degree 76 (5.0) 10.92±3.39b a>b
    Religion Yes 792 (52.1) 11.52±4.10 0.99
    No 727 (47.9) 11.31±4.16 (.320)
    Marital status First marriage 1,501 (98.8) 11.40±4.13 -1.87
    Others 18 (1.2) 13.17±4.22 (.014)
    Job status Yes 477 (31.4) 10.97±3.95 2.86
    No 1,042 (68.6) 11.62±4.20 (.004)
    Living with infant Yes 1,488 (98.0) 11.38±4.10 -1.87
    No 31 (2.0) 13.19±5.42 (.014)
    Living with infant's father Yes 1,458 (96.0) 11.41±4.11 -0.17
    No 61 (4.0) 11.51±4.71 (.862)
    Smoking Yes 23 (1.5) 15.61±5.84 3.48
    No 1,496 (98.5) 11.35±4.07 (.002)
    Drinking Yes 535 (35.2) 11.95±4.28 -3.71
    No 984 (64.8) 11.13±4.02 (<.001)
    Father's demographic characteristics  Age (year) 20~29 138 (9.1) 11.68±4.54 0.54
    30~39 1,221 (80.4) 11.42±4.15 (.581)
    ≥40 160 (10.5) 11.18±3.60  
    Educational level ≤High school 392 (25.8) 11.99±4.61a 8.79
    College & university 973 (64.1) 11.35±3.98a (<.001)
    ≥Master degree 154 (10.1) 10.40±3.51b a>b
    Religion Yes 672 (44.2) 11.18±3.98 -2.01
    No 847 (55.8) 11.61±4.24 (.044)
    Job status Yes 1,494 (98.4) 11.42±4.14 0.17
    No 25 (1.6) 11.56±3.73 (.862)
    Smoking Yes 799 (52.6) 11.77±4.38 3.57
    No 720 (47.4) 11.02±3.81 (<.001)
    Drinking Yes 1,195 (78.7) 11.54±4.15 2.30
    No 324 (21.3) 10.95±4.05 (.021)
    Infant's and toddler's characteristics Gender Boy 763 (50.2) 11.44±4.13 0.17
    Girl 11~12 756 (48.8) 11.40±4.13 (.861)
    Age (month) 11~12 97 (6.4) 12.33±4.08a 3.00
    13~15 1,305 (85.9) 11.32±4.07b (.050)
    16~18 117 (7.7) 11.71±4.75a,b a>b
    Korean-age & stage Total
     Number of below broken line 0~1 1,494 (98.0) 11.37±4.10 -3.31
     Number of below broken line≥2 25 (2.0) 14.12±5.17 (.001)
    DDST II Normal development 1,146 (75.4) 11.38±4.09 -0.59
    Suspected development 373 (24.6) 11.53±4.27 (.553)
    Treatment due to accident/poisoning Yes 237 (15.6) 11.69±3.95 1.09
    No 1,282 (84.4) 11.37±4.17 (.274)
    Hospitalization in past Yes 317 (20.9) 11.67±4.43 1.15
    No 1,202 (79.1) 11.35±4.05 (.249)
    Family's economic status The national basic living security system state People on basic welfare 15 (1.0) 11.20±4.96 0.85
    Those in the second-to-the bottom income bracket 62 (4.1) 12.08±4.09 (.429)
    No 1,442 (94.9) 11.39±4.13  
    House One's own house/ leased house 1,372 (90.3) 11.33±4.08 -2.68
    Rental house/monthly rent house/others 147 (9.7) 12.29±4.49 (.007)

    a, b: Duncan grouping.

    Correlation of Influencing Factors to Maternal Depression Scores (N=1,519)

    Variables   Categories Depression scores
    r(p)
    Mother's independent variables Marital satisfaction   -.32 (<.001)
    Marital conflict   .48 (<.001)
    Paternal participation in child rearing   -.23 (<.001)
    Social support   -.32 (<.001)
    Self-efficacy   .54 (<.001)
    Self-esteem   -.55 (<.001)
    Parenting stress   .51 (<.001)
    Child rearing: parental style   -.34 (<.001)
    Knowledge of child rearing   -.08 (.001)
    Value of children Emotional value -.26 (<.001)
    Instrumental value -.12 (<.001)
    Father's independent characteristics  Marital satisfaction   -.21 (<.001)
    Marital conflict   .32 (<.001)
    Value of children Emotional value -.09 (<.001)
    Instrumental value -.04 (.141)
    Infant's and toddler's independent characteristics Temperament survey Emotionality .27 (<.001)
    Activity .01 (.681)
    Developmental profiles-daily routines Sleep -.01 (.613)
    Feeding & eating .05 (.033)
    Bowel/washing -.04 (.166)
    Total .00 (.920)
    Korean-ages & stage Communication -.02 (.432)
    Gross motor -.07 (.005)
    Fine motor -.01 (.596)
    Problem solving -.02 (.450)
    Personal-social -.07 (.004)
    Family's economic status Average monthly income (10,000 won)   -.13(<.001)

    Factors Influencing on Mother's Depression (N=1,519)

    Variables β SE Std. β t p Partial R2 Accum. R2
    Intercept 3.90 0.81   4.80 <.001    
    Mother's self-efficacy 0.52 0.04 0.34 14.99 <.001 .304 .304
    Mother's marital conflict 0.17 0.02 0.25 10.53 <.001 .058 .362
    Mother's social support -0.06 0.01 -0.12 -5.55 <.001 .014 .376
    Infant's and toddler's emotionality 0.14 0.03 0.11 5.49 <.001 .012 .388
    Mother's smoking (ref non-smoking) 2.26 0.77 0.07 2.93 .003 .004 .392
    Infant's and toddler's feeding & eating of daily routine 0.08 0.03 0.05 2.82 .004 .003 .395
    R2=.395, Adj. R2=.392, F=164.26, p<.001

    Std. β=Standardized β; Accum. β=Accumulated R2.

    Table 1. Mothers' General Characteristics (N=1,519)

    Table 2. Influencing Factors (N=1,519)

    Table 3. Comparison of Maternal Depression Scores (N=1,519)

    : Duncan grouping.

    Table 4. Correlation of Influencing Factors to Maternal Depression Scores (N=1,519)

    Table 5. Factors Influencing on Mother's Depression (N=1,519)

    Std. β=Standardized β; Accum. β=Accumulated R2.

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