Heterogeneity in perinatal depression and its related factors: a longitudinal study in Beijing, China

Perinatal depressive symptoms are prevalent yet frequently overlooked. Few studies in China have characterised heterogeneity in depressive symptom trajectories across multiple time points from pregnancy to the postpartum period. This study examined patterns of perinatal depressive symptoms and factors associated with differences between trajectories. Women were recruited from a prospective cohort and assessed repeatedly from early mid-pregnancy to three months postpartum. Depressive symptoms weremeasured using the Edinburgh Postnatal Depression Scale. Sociodemographic, physical, and psychosocial information was collected at enrolment. Longitudinal modelling was used to identify distinct symptom trajectories, and regression analyses examined factors associated with trajectory membership. Two distinct depressive symptom trajectories were identified. Most women showed relatively low symptom levels with an overall gradual increase over time, whereas a smaller subgroup exhibited persistently elevated symptoms. Older maternal age, higher social support, and greater marital satisfaction were associated with a lower likelihood of persistently elevated symptoms, while personal and family histories of depression were associated with greater symptom persistence across the perinatal period. This was a single-centre study. Depressive symptoms were not assessed during the first trimester. Perinatal depressive symptom trajectories exhibit heterogeneity. Differences in patterns of symptom persistence were associated with maternal age, social support, marital satisfaction, personal and family histories of depression. These findings highlight the value of continuous and dynamic assessment of perinatal depressive symptoms incorporates key psychosocial and clinical characteristics to inform monitoring. Improving awareness of perinatal mental health, strengthening family and social support may facilitate earlier identification and management. • Perinatal depressive symptoms exhibit heterogeneity from pregnancy to postpartum. • Two distinct depressive symptom trajectories were identified in a large longitudinal cohort. • Most women showed low-increasing symptoms, while a smaller group had persistently elevated symptoms. • Older age, higher social support and marital satisfaction were linked to lower symptom levels. • Personal and family histories of depression were associated with persistently elevated symptoms.