Trajectories of Depressive Symptoms in the First Year Postpartum and Their Associated Factors Among Chinese Women

OBJECTIVE: The development patterns of depressive symptoms throughout the first year postpartum among Chinese women remain unclear. This study aimed to identify the trajectories of postpartum depressive symptoms over this period and explore factors associated with different trajectories. METHODS: A longitudinal study was conducted at two women's and children's hospitals in China. Postpartum depressive symptoms were assessed at 1, 3, 6, and 12 months after childbirth. Participants who completed at least three follow-up assessments were included in the final analysis. A group-based trajectory model was used to identify trajectories of postpartum depressive symptoms, and multivariable logistic regression was performed to explore factors associated with trajectory groups. RESULTS: Three trajectories were identified: "low-stable" (35.0%), "moderate-stable" (51.3%), and "high-stable" (13.7%), characterised by low, moderate, and high symptom levels at all waves, respectively. Employment status, antenatal depressive symptoms, postpartum complications, family function, and parenting sense of competence were associated with both the "moderate-stable" and "high-stable" trajectories. Additionally, feeding patterns and negative life events were related to "moderate-stable" and "high-stable" trajectories, respectively. CONCLUSIONS: The findings demonstrate remarkable stability of depressive symptom trajectories throughout the first postpartum year. It is suggested to conduct depressive symptoms screening and intervention according to relevant risk factors for women in the early postpartum period.