Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study

Abstract Background Antenatal depression symptom is a global health concern, but the trajectories of antenatal depression symptom vary across different studies. Additionally, the influencing factors and adverse pregnancy outcomes of antenatal depression symptom may differ across heterogeneous subtyp...

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Main Authors: Jianfei Chen, Siqi Li, Sai Yang, Yang Chen, Jackson Jr Nforbewing Ndenkeh, Intan Maharani Sulistyawati Batubara, Luyang Zhu, Jun Liu, Xinlong Pan, Zhijie Zou, Cuifang Fan, Xiaoli Chen, Zhao Ni
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825100588/type/journal_article
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author Jianfei Chen
Siqi Li
Sai Yang
Yang Chen
Jackson Jr Nforbewing Ndenkeh
Intan Maharani Sulistyawati Batubara
Luyang Zhu
Jun Liu
Xinlong Pan
Zhijie Zou
Cuifang Fan
Xiaoli Chen
Zhao Ni
author_facet Jianfei Chen
Siqi Li
Sai Yang
Yang Chen
Jackson Jr Nforbewing Ndenkeh
Intan Maharani Sulistyawati Batubara
Luyang Zhu
Jun Liu
Xinlong Pan
Zhijie Zou
Cuifang Fan
Xiaoli Chen
Zhao Ni
author_sort Jianfei Chen
collection DOAJ
description Abstract Background Antenatal depression symptom is a global health concern, but the trajectories of antenatal depression symptom vary across different studies. Additionally, the influencing factors and adverse pregnancy outcomes of antenatal depression symptom may differ across heterogeneous subtypes, which requires further exploration. Methods A prospective cohort study was conducted in Hubei province, China, from July 2022 to September 2023. Pregnant women (<14 weeks) were enrolled and followed up at 16, 21, 28, and 37 gestational weeks, with depressive symptom measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent class growth modeling and logistic regression were used for data analysis. Results Of 1034 women enrolled, 725 completed all follow-ups. Four depressive symptom trajectories were identified: no depression group (32.13%), persistent subclinical depression group (42.48%), persistent moderate depression group (19.17%), and persistent high depression group (6.21%). Risk factors of depressive symptom trajectories included low social capital, unplanned pregnancy, primiparity, mental illness history, high perceived stress, and low resilience (p < 0.05). Compared to the no depression group, gestational diabetes mellitus (GDM) risk was 1.90 times higher in the persistent moderate group and 2.59 times higher in the persistent high group; small for gestational age (SGA) risk was 2.42 times higher in the persistent moderate group and 3.98 times higher in the persistent high group. Conclusions This study identified four antenatal depressive symptom trajectories. Persistent moderate and high depression groups were linked to GDM and SGA, highlighting the importance of mental health assessments and intervention for pregnant women, especially those with higher depression severity, to prevent adverse outcomes.
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spelling doaj-art-68338abdeb964dfb8d86c3fa68141ea02025-08-20T09:20:13ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10058Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort studyJianfei Chen0https://orcid.org/0000-0003-1085-6841Siqi Li1https://orcid.org/0009-0009-6832-8727Sai Yang2Yang Chen3https://orcid.org/0009-0007-1449-0492Jackson Jr Nforbewing Ndenkeh4https://orcid.org/0000-0003-1437-660XIntan Maharani Sulistyawati Batubara5https://orcid.org/0000-0002-8912-8603Luyang Zhu6https://orcid.org/0000-0002-3344-9600Jun Liu7Xinlong Pan8https://orcid.org/0009-0003-3901-7731Zhijie Zou9Cuifang Fan10Xiaoli Chen11Zhao Ni12https://orcid.org/0000-0002-9185-9894School of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaDepartment of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, https://ror.org/03v76x132 Yale University , New Haven, CT, USASchool of Nursing, https://ror.org/03v76x132 Yale University , New Haven, CT, USASchool of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaDepartment of Obstetrics, https://ror.org/03ekhbz91 Renmin Hospital of Wuhan University , Wuhan, ChinaSchool of Nursing, Wuhan University, Wuhan, ChinaSchool of Nursing, https://ror.org/03v76x132 Yale University , New Haven, CT, USAAbstract Background Antenatal depression symptom is a global health concern, but the trajectories of antenatal depression symptom vary across different studies. Additionally, the influencing factors and adverse pregnancy outcomes of antenatal depression symptom may differ across heterogeneous subtypes, which requires further exploration. Methods A prospective cohort study was conducted in Hubei province, China, from July 2022 to September 2023. Pregnant women (<14 weeks) were enrolled and followed up at 16, 21, 28, and 37 gestational weeks, with depressive symptom measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent class growth modeling and logistic regression were used for data analysis. Results Of 1034 women enrolled, 725 completed all follow-ups. Four depressive symptom trajectories were identified: no depression group (32.13%), persistent subclinical depression group (42.48%), persistent moderate depression group (19.17%), and persistent high depression group (6.21%). Risk factors of depressive symptom trajectories included low social capital, unplanned pregnancy, primiparity, mental illness history, high perceived stress, and low resilience (p < 0.05). Compared to the no depression group, gestational diabetes mellitus (GDM) risk was 1.90 times higher in the persistent moderate group and 2.59 times higher in the persistent high group; small for gestational age (SGA) risk was 2.42 times higher in the persistent moderate group and 3.98 times higher in the persistent high group. Conclusions This study identified four antenatal depressive symptom trajectories. Persistent moderate and high depression groups were linked to GDM and SGA, highlighting the importance of mental health assessments and intervention for pregnant women, especially those with higher depression severity, to prevent adverse outcomes. https://www.cambridge.org/core/product/identifier/S0924933825100588/type/journal_articleadverse pregnancy outcomesantenatal depressionrisk factorstrajectoriescohort study
spellingShingle Jianfei Chen
Siqi Li
Sai Yang
Yang Chen
Jackson Jr Nforbewing Ndenkeh
Intan Maharani Sulistyawati Batubara
Luyang Zhu
Jun Liu
Xinlong Pan
Zhijie Zou
Cuifang Fan
Xiaoli Chen
Zhao Ni
Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
European Psychiatry
adverse pregnancy outcomes
antenatal depression
risk factors
trajectories
cohort study
title Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
title_full Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
title_fullStr Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
title_full_unstemmed Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
title_short Trajectories of antenatal depression and adverse pregnancy outcomes: A prospective cohort study
title_sort trajectories of antenatal depression and adverse pregnancy outcomes a prospective cohort study
topic adverse pregnancy outcomes
antenatal depression
risk factors
trajectories
cohort study
url https://www.cambridge.org/core/product/identifier/S0924933825100588/type/journal_article
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