A network analysis of mental, somatic health, and perceived social supports among Chinese pregnant and postpartum women

Background: The mental burdens among pregnant and postpartum women were exacerbated by cultural expectations and policy shifts, which can be mitigated by social support. Objective: To identify the networks of comorbid somatic and mental health, diverse sources of support (interpersonal and policy), and symptom–support interactions in pregnant and postpartum women. Methods: Participants were recruited from seven Chinese tertiary hospitals. Health conditions, supports, and combined system networks were estimated. Core symptoms and support sources were identified via centrality indices. Results: Two thousand nine hundred and eighty-nine participants were included, network analysis identified ‘feeling tired/having low energy’ and ‘suicidal thoughts’ in depression symptoms as the most central symptoms. Strongest edges were identified between ‘uncontrollable worry-trouble relaxing’ (anxiety), ‘slowed movement-suicidal thoughts’ (depression), and ‘feeling your heart pound or race-shortness of breath’ (somatic symptoms). Somatic health exhibited strong connections with depression symptoms, especially between ‘trouble sleeping’ and ‘sleep problems’. In the support network, ‘my friends offer practical help’ and ‘fiscal assistance programs’ exhibited highest strength centrality, ‘friends share joys and sorrows with me’ and ‘family willingly helps me make decisions’ were key mediators with high betweenness. All supports were negatively associated with mental/somatic symptoms. Family and friend support had stronger negative connections with hopelessness. ‘Health management’, ‘reliable friends’, and ‘family emotional support’ presented the strongest negative relationships with mental health. Conclusion: Fatigue and suicidal ideation were identified as interconnected symptoms, informal interpersonal support, and fiscal assistance as key elements. Preventions and interventions should prioritize core symptoms while leveraging the power of support networks, to safeguard maternal health and well-being.