Prevalence and influencing factors of perinatal depression across different stages of pregnancy and postpartum: a cross-sectional study in China

Background: Perinatal depression (PND) is a major public health concern, affecting both maternal and infant health. While numerous studies have examined risk factors for PND, most focused on single pregnancy stages, with limited evidence spanning the full perinatal period. This study aimed to assess the prevalence of PND across pregnancy and postpartum, and identify stage-specific influencing factors among Chinese women. Methods: A cross-sectional study was conducted among 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 within 6 weeks postpartum (T4), recruited from The Third Xiangya Hospital of Central South University. Demographic, psychological, and physiological data were collected, and PND was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS, cutoff ≥10). Results: The prevalence of PND was 30.95% at T1, 20.81% at T2, 18.29% at T3, and 28.07% at T4. Influencing factors varied across stages: in T1, relationship status, partner characteristics, family functioning, stress, and sleep quality were significant; in T2, health insurance, life events, social support, and sleep quality played key roles; in T3, family income, partner occupation, and family functioning were associated with PND; in T4, minority status, parental self-efficacy, history of ectopic pregnancy, and infant feeding method emerged as significant predictors. Conclusion: The prevalence and determinants of PND differ markedly across pregnancy and postpartum. These findings highlight the importance of stage-specific screening and tailored interventions: addressing relationship and family dynamics in early pregnancy, social support and healthcare access in mid-pregnancy, financial stability in late pregnancy, and parenting-related stressors postpartum. Targeted strategies may improve prevention and management of PND and ultimately enhance maternal mental health outcomes.