目的 探讨孕妇压力知觉与其产前抑郁情绪间的关系及机制，为临床开展孕妇产前抑郁干预提供借鉴。方法 2020年6月至2021年1月，便利抽取广州市4所三级甲等医院门诊孕妇，使用爱丁堡产后抑郁量表、压力知觉量表、反刍思维量表和情绪调节问卷开展调查。结果 1055名被调查的孕妇产前抑郁情绪检出率为37.53%，产前抑郁与压力知觉、反刍思维均呈正相关（r=0.308,0.554,均P＜0.01），与其认知重评呈负相关（r=-0.183,P＜0.01）。孕妇反刍思维在其压力知觉和抑郁情绪间起中介作用，占总效应58.71%；认知重评在反刍思维中介模型中起调节作用（P＜0.01）；当孕妇认知重评水平较高时，压力知觉对其抑郁情绪间接预测作用较弱（β=0.652,0.222,均P＜0.01），反之增强（β=0.987,0.291,均P＜0.01）。结论 孕妇压力知觉可直接或通过反刍思维间接影响其抑郁情绪，并受认知重评调节。临床可通过提高孕妇认知重评水平，降低反刍思维，开展有针对性的产前抑郁干预。

Objective To explore the relationship and mechanisms between perceived stress and prenatal depression among pregnant women.Methods Convenient sampling was employed to select 1055 pregnant women from outpatient clinics of four tertiary A hospitals in Guangzhou from June 2020 to January 2021.The Edinburgh Postnatal Depression Scale,Perceived Stress Scale,Ruminative Response Scale and Emotional Regulation Questionnaire were used for investigation.Results The detection rate of prenatal depression among 1055 pregnant women was 37.53%.Prenatal depression was positively correlated with perceived stress and rumination (r=0.308,0.554,all P＜0.01),and negatively associated with cognitive reappraisal (r=-0.183,P＜0.01).Rumination played a mediating role between perceived stress and prenatal depression,accounting for 58.71% of the total effect.Cognitive reappraisal played a moderating role on the mediating role of rumination (P＜0.01).When cognitive reappraisal levels were high,the indirect predictive effect of perceived stress on prenatal depression was weaker (β=0.652,0.222,all P＜0.01),and vice versa (β=0.987,0.291,all P＜0.01).Conclusions The perceived stress can directly or indirectly influence prenatal depression through rumination,and is moderated by cognitive reappraisal among pregnant women.In clinical practice,targeted prenatal depression interventions can be conducted by enhancing the cognitive reappraisal levels of pregnant women and reducing rumination.

R473.71

国家自然科学基金面上项目（72274090、71874075）；南方医科大学2023年度大学生创新创业训练计划项目（202312121253）