Fan Zina, Wang Jiayi, Liu Xinyue, Peng Ke, Zhou Ying, Yin Xiaoxv, Gong Yanhong
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
School of Public Health, College of Medicine, Shanghai Jiaotong University, Shanghai 200025, China.
Asian J Psychiatr. 2025 May;107:104453. doi: 10.1016/j.ajp.2025.104453. Epub 2025 Mar 22.
Antenatal depression is a critical factor affecting maternal health. However, the heterogeneous profiles of antenatal depression across pregnancy, the evolving patterns of profile transitions over time, and their predictors remain unclear. This study aims to identify the latent profiles of antenatal depressive symptoms in pregnant women, analyze the developmental patterns of risk type transitions over time, and explore key predictors of the probabilities of profile transitions during pregnancy.
A longitudinal follow-up study was conducted in two cities in China, involving 856 pregnant women who met the inclusion criteria and completed surveys during early, mid, and late pregnancy. Data were analyzed using Latent Profile Analysis (LPA) and Latent Transition Analysis (LTA). LPA was employed to identify latent profiles of antenatal depression, while LTA was used to explore longitudinal patterns of profile transitions from early to late pregnancy. Regression mixture models and logistic regression analyses were applied to examine the associations between demographic characteristics, family functioning, and the distinct latent profiles of antenatal depression as well as their developmental transitions. The Harman single-factor test was used to assess common method bias.
Antenatal depression demonstrates developmental heterogeneity across pregnancy and can be categorized into four distinct subgroups. Latent Transition Analysis (LTA) revealed that pregnant women in the low depressive symptom group were more likely to remain stable over time, with a stability probability of 86 %. In contrast, those in the high depressive symptoms group showed a higher likelihood of transitioning (20 %), with probabilities of shifting to the moderate anhedonia group and the low anhedonia group both at 32 %. Educational attainment, physical activity, and family functioning were identified as significant predictors of antenatal depression profiles (P < 0.01). Furthermore, age, educational level, residence, employment status, physical activity, and family functioning were significant predictors of the transition probabilities between antenatal depression profiles over time (P < 0.01).
The latent profiles of antenatal depressive symptoms exhibit relatively stable transition patterns throughout pregnancy. Education level, physical activity, and family functioning are significant predictors of these profiles and their transition probabilities over time. The impact of prenatal depression on maternal and offspring health poses not only short-term threats but also long-term multidimensional health burdens. Comprehensive early screening for depressive symptoms, combined with continuous and personalized intervention strategies tailored to prenatal depression profiles, should be integrated into standard prenatal care.
产前抑郁是影响孕产妇健康的关键因素。然而，孕期产前抑郁的异质性特征、这些特征随时间演变的模式及其预测因素仍不明确。本研究旨在识别孕妇产前抑郁症状的潜在特征，分析风险类型随时间转变的发展模式，并探索孕期特征转变概率的关键预测因素。
在中国的两个城市进行了一项纵向随访研究，纳入856名符合纳入标准并在孕早期、孕中期和孕晚期完成调查的孕妇。使用潜在剖面分析（LPA）和潜在转变分析（LTA）对数据进行分析。LPA用于识别产前抑郁的潜在特征，而LTA用于探索从孕早期到孕晚期特征转变的纵向模式。应用回归混合模型和逻辑回归分析来检验人口统计学特征、家庭功能与产前抑郁的不同潜在特征及其发展转变之间的关联。采用Harman单因素检验评估共同方法偏差。
产前抑郁在孕期表现出发育异质性，可分为四个不同的亚组。潜在转变分析（LTA）显示，低抑郁症状组的孕妇随时间保持稳定的可能性更大，稳定概率为86%。相比之下，高抑郁症状组的孕妇转变的可能性更高（20%），转变为中度快感缺乏组和低度快感缺乏组的概率均为32%。教育程度、体育活动和家庭功能被确定为产前抑郁特征的重要预测因素（P<0.01）。此外，年龄、教育水平、居住地、就业状况、体育活动和家庭功能是产前抑郁特征随时间转变概率的重要预测因素（P<0.01）。
产前抑郁症状的潜在特征在整个孕期呈现出相对稳定的转变模式。教育水平、体育活动和家庭功能是这些特征及其随时间转变概率的重要预测因素。产前抑郁对孕产妇和后代健康的影响不仅构成短期威胁，还带来长期的多维度健康负担。应将抑郁症状的综合早期筛查与针对产前抑郁特征的持续个性化干预策略纳入标准产前护理。
