Social capital and maternal mental health: Findings from secondary data analyses of two linked longitudinal trials in Australia

Zoe Chen; Huilan Xu; Philayrath Phongsavan; Lisa Simone; Louise A Baur; Li Ming Wen

doi:10.1016/j.midw.2025.104306

Social capital and maternal mental health: Findings from secondary data analyses of two linked longitudinal trials in Australia

Midwifery. 2025 Jan 22:142:104306. doi: 10.1016/j.midw.2025.104306. Online ahead of print.

Authors

Zoe Chen¹, Huilan Xu², Philayrath Phongsavan³, Lisa Simone⁴, Louise A Baur⁵, Li Ming Wen⁶

Affiliations

¹ Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia.
² Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Australia.
³ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre, The University of Sydney, Australia.
⁴ Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Australia.
⁵ Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre, The University of Sydney, Australia; NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), Australia; Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia.
⁶ Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Australia; Charles Perkins Centre, The University of Sydney, Australia; NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), Australia. Electronic address: liming.wen@health.nsw.gov.au.

PMID: 39864145
DOI: 10.1016/j.midw.2025.104306

Abstract

Problem: Low social capital has been identified as an important risk factor in the development of postpartum mental illness.

Background: Evidence suggests that new and expectant mothers with higher levels of support have lower rates of maternal mental illness, yet few studies examine this relationship longitudinally.

Aim: This study investigated the association between social capital in late pregnancy and maternal mental health up to 5 years postpartum.

Methods: Secondary analysis of Communicating Healthy Beginnings Advice by Telephone trial data was conducted. Participants included women in late pregnancy recruited from seven Australian hospitals across New South Wales (n=1155). Outcomes were maternal stress at 6 months postpartum, and psychological distress at 3, 4, and 5 years postpartum. Data on demographics and maternal cognitive, structural, and total social capital were collected in late pregnancy. Multiple logistic regression was conducted at 6 months postpartum, and longitudinal analysis with multilevel mixed-effects logistic regression conducted from 3 to 5 years postpartum.

Findings: Lower total social capital was associated with an increased likelihood of having higher stress at 6 months postpartum (AOR 1.61, 95 % CI 1.21-2.14). Lower total social capital was also associated with anxiety (AOR 1.44, 95 % CI 1.01-2.05) and higher levels of psychological distress (AOR 1.50, 95 % CI 1.15-1.95) at 3 to 5 years postpartum.

Conclusions: Findings suggest that improving social capital in late pregnancy can mitigate postpartum mental health symptoms. Efforts to increase the social capital of new and expectant mothers should be made to prevent their mental illness postpartum.

Keywords: Cross-sectional analysis; Longitudinal study; Maternal health; Mental health; Postpartum depression; Social capital.