Prevalence and Influencing Factors of Perinatal Depression Across Different Stages of Pregnancy and Postpartum: A Cross-Sectional Study in China

Bing Fu¹Siyuan Zhang²Linghui Xiang²Mengsi Cai²Mengxin Ou²Guanxiu Tang³Ruirui Huang⁴Jun Lei^3*Xin Lu^5*

• ¹Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
• ²College of Systems Engineering, National University of Defense Technology, Changsha, China
• ³The Third Xiangya Hospital of Central South University, Changsha, China
• ⁴Hunan University of Medicine, Huaihua, China
• ⁵National University of Defense Technology, Changsha, China

Background: Perinatal depression (PND) is a major global public health concern, affecting both maternal and infant health. While previous studies have identified risk factors for PND, most have focused on specific pregnancy stages, with limited research addressing the full perinatal period. This study aims to assess the prevalence of PND among Chinese women across the pregnancy and postpartum, and identify the factors influencing its occurrence at each stage. Methods: This cross-sectional study recruited 1,047 participants in early pregnancy (T1: ≤13 weeks), 543 in mid-pregnancy (T2: 14–27 weeks), 421 in late pregnancy (T3: 28 weeks to delivery), and 424 in the postpartum period (T4: within 6 weeks) from The Third Xiangya Hospital of Central South University. Demographic, psychological, and physiological data were collected at each stage. Perinatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), with a threshold score of ≥10 indicating depression. Results: Among participants, 30.95% exhibited symptoms of PND during T1, 20.81% during T2, 18.29% during T3, and 28.07% during T4. In T1, PND was associated with factors such as being single, the partner's age and occupation, relationships with in-laws, family functioning, stress levels, and sleep quality. During T2, key factors influencing PND included the type of health insurance, family functioning, negative life events, low social support, and poor sleep quality. In T3, PND was primarily associated with the partner's occupation, family income, family functioning, and sleep quality. In T4, PND was influenced by minority status, negative life events, parenting stress, parental self-efficacy, a history of ectopic pregnancy, and bottle-feeding. Conclusion: This study demonstrates that the prevalence and influencing factors of PND vary significantly across different stages of pregnancy and postpartum. The findings underscore the necessity for stage-specific interventions, as each period is characterized by distinct contributing factors, such as relationship status and family dynamics in T1, social support and health insurance in T2, financial stability in T3, and parenting stress in T4. Tailoring interventions to address these stage-specific factors, along with recognizing periods of higher prevalence, can lead to more effective prevention and management of PND, ultimately improving maternal mental health outcomes.