Association between biological rhythm disturbance and depressive symptoms among pregnant women in early pregnancy：the mediating role of perceived stress and the moderating role of psychological resilience

Song Xinwei; Lü Furong; Du Lian

doi:10.13406/j.cnki.cyxb.004162

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Association between biological rhythm disturbance and depressive symptoms among pregnant women in early pregnancy：the mediating role of perceived stress and the moderating role of psychological resilience

Frontiers in brain science and neuropsychiatric disorders | 更新时间：2026-10-26

- Association between biological rhythm disturbance and depressive symptoms among pregnant women in early pregnancy：the mediating role of perceived stress and the moderating role of psychological resilience
- Journal of Chongqing Medical University Vol. 51, Issue 10, Pages: 1411-1420(2026)
- 作者机构：
  
  1.重庆医科大学附属第一医院精神科，重庆　400016
  2.重庆医科大学附属第一医院放射科，重庆　400016
  3.重庆医科大学附属第一医院精神科，重庆　400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004162
  CLC： R749.92
- Received：01 July 2026，
  
  Revised：2026-07-23，
  
  Accepted：03 August 2026，
  
  Published：28 October 2026
- 稿件说明：
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宋昕蔚，吕富荣，杜莲.妊娠早期抑郁症状与生物节律紊乱的关系：感知压力的中介作用及心理弹性的调节作用[J].重庆医科大学学报，2026，51（10）：1411-1420.

Song Xinwei,Lü Furong,Du Lian.Association between biological rhythm disturbance and depressive symptoms among pregnant women in early pregnancy：the mediating role of perceived stress and the moderating role of psychological resilience[J].Journal of Chongqing Medical University,2026,51(10):1411-1420.
宋昕蔚，吕富荣，杜莲.妊娠早期抑郁症状与生物节律紊乱的关系：感知压力的中介作用及心理弹性的调节作用[J].重庆医科大学学报，2026，51（10）：1411-1420. DOI： 10.13406/j.cnki.cyxb.004162.

Song Xinwei,Lü Furong,Du Lian.Association between biological rhythm disturbance and depressive symptoms among pregnant women in early pregnancy：the mediating role of perceived stress and the moderating role of psychological resilience[J].Journal of Chongqing Medical University,2026,51(10):1411-1420. DOI： 10.13406/j.cnki.cyxb.004162.

摘要

目的

探讨妊娠早期生物节律紊乱程度与抑郁症状的关联，并检验感知压力的中介效应、心理弹性的调节效应及有调节的中介效应。

方法

本研究于重庆医科大学附属第一医院产科门诊招募妊娠早期孕妇，最终纳入857例。采用神经精神科生物节律评估访谈（Biological Rhythms Interview of Assessment in Neuropsychiatry，BRIAN）、感知压力量表（Perceived Stress Scale，PSS）、心理弹性量表（Connor-Davidson Resilience Scale，CD-RISC）和患者健康问卷抑郁量表（Patient Health Questionnaire-9，PHQ-9），分别评估妊娠早期孕妇的生物节律紊乱程度、感知压力、心理弹性及抑郁症状。变量间相关性采用Pearson相关分析，采用SPSS 27.0软件中的PROCESS宏程序进行有调节的中介效应检验，Bootstrap重复抽样5 000次。

结果

最终纳入857例妊娠早期孕妇进行分析，抑郁症状检出率为10.5%。生物节律紊乱与感知压力、抑郁症状呈正相关（

=0.428、0.727，

0.001），心理弹性与三者分别呈负相关（

=-0.443、-0.563、-0.701，

0.001）。感知压力在生物节律紊乱与妊娠早期抑郁症状间起部分中介作用，间接效应为0.056，95%置信区间（confidence interval，CI）为0.044~0.069，占总效应的20.5%。心理弹性显著调节“生物节律紊乱→抑郁症状”（

=-0.003，

0.001）及“感知压力→抑郁症状”（

=-0.005，

0.001）2条路径，即心理弹性水平越高，生物节律紊乱和感知压力对抑郁症状的正向关联越弱。

结论

生物节律紊乱和感知压力是妊娠早期孕妇抑郁症状的重要关联因素，心理弹性可减弱其不良影响。建议在产科常规筛查中纳入以上指标，并开展将节律调整、压力管理与心理弹性培养相结合的早期干预，以降低妊娠早期孕妇的抑郁症状筛查阳性风险，改善母婴健康结局。

Abstract

Objective

To investigate the association between the degree of biological rhythm disruption and depressive symptoms among women in early pregnancy，and to examine the mediating role of perceived stress as well as the moderated mediation effect of psychological resilience.

Methods

A total of 857 women in early pregnancy were included from the obstetric outpatient clinic of the First Affiliated Hospital of Chongqing Medical University. The degree of biological rhythm disruption，perceived stress，psychological resilience，and depressive symptoms were assessed using the Biological Rhythms Interview of Assessment in Neuropsychiatry，the Perceived Stress Scale，the Connor–Davidson Resilience Scale，and the Patient Health Questionnaire-9，respectively. Pearson correlation analysis was used to examine the correlations among variables. Moderated mediation analysis was conducted using the PROCESS macro in SPSS version 27.0，with 5 000 bootstrap resamples.

Results

A total of 857 valid questionnaires were included in the analysis，and the detection rate of depressive symptoms was 10.5%. Biological rhythm disruption was positively correlated with both perceived stress and depressive symptoms（

=0.428，0.727，both

0.001），whereas psychological resilience was negatively correlated with biological rhythm disruption， perceived stress and depressive symptoms（

=-0.443，-0.563，-0.701，all

0.001）. Perceived stress partially mediated the association between biological rhythm disruption and depressive symptoms，with an indirect effect of 0.056，95%CI=0.044~0.069，accounting for 20.5% of the total effect. Psychological resilience significantly moderated both the path “from biological rhythm disruption to depressive symptoms”（

B=-

0.003

，P<

0.001） and the path “from perceived stress to depressive symptoms”（

=-0.005，

0.001）. As the level of psychological resilience increased，the effects of biological rhythm disruption and perceived stress on depressive symptoms gradually decreased.

Conclusion

Biological rhythm disturbance and perceived stress are important correlates of depressive symptoms in early pregnancy，while psychological resilience may buffer their adverse effects. Routine obstetric screening should incorporate these indicators，and early interventions integrating rhythm regulation，stress management， and resilience enhancement may help reduce depressive symptom risk and improve maternal and infant health outcomes.

关键词

Keywords

references

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