He Zi-Ping, Cheng Jun-Zhe, Yu Yan, Wang Yu-Bo, Wu Chen-Kun, Ren Zhi-Xuan, Peng Yi-Lin, Xiong Jin-Tao, Qin Xue-Mei, Peng Zhuo, Mao Wei-Guo, Chen Ming-Fang, Zhang Li, Ju Yu-Meng, Liu Jin, Liu Bang-Shan, Wang Mi, Zhang Yan
Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China.
Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China.
World J Psychiatry. 2025 Apr 19;15(4):100650. doi: 10.5498/wjp.v15.i4.100650.
Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring. Early identification and intervention of antenatal depression can help to prevent adverse outcomes. However, there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.
To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.
The cross-sectional survey was conducted in Shenzhen, China from 2020 to 2024. Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥ 13 indicating the presence of probable antenatal depression. The test and binary logistic regression were used to identify the factors associated with antenatal depression. Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.
Among the 44220 pregnant women, the prevalence of probable antenatal depression was 4.4%. An age ≤ 24 years, a lower level of education (≤ 12 years), low or moderate economic status, having a history of mental disorders, being in the first trimester, being a primipara, unplanned pregnancy, and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression (all < 0.05). Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms. EPDS8 ("sad or miserable") and EPDS4 ("anxious or worried") showed the highest nodal strength across groups with different risk levels.
This study suggested that the prevalence of antenatal depression was 4.4%. Several social and obstetric factors were identified as risk factors for antenatal depression. EPDS8 ("sad or miserable") and EPDS4 ("anxious or worried") are pivotal targets for clinical intervention to alleviate the burden of antenatal depression. Early identification of high-risk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
产前抑郁是孕妇中一种致残性精神障碍，可能对母亲和后代均造成不良后果。早期识别和干预产前抑郁有助于预防不良后果。然而，在中国，很少有基于人群的研究关注社会和产科风险因素与产前抑郁之间的关联。
基于大量中国人群，评估产前抑郁的社会人口学和产科因素，并比较不同风险水平下抑郁症状的网络结构。
于2020年至2024年在中国深圳进行横断面调查。使用中文版爱丁堡产后抑郁量表（EPDS）评估产前抑郁，得分≥13分表明可能存在产前抑郁。采用检验和二元逻辑回归确定与产前抑郁相关的因素。进行网络分析以研究不同风险水平组中抑郁症状的结构。
在44220名孕妇中，可能的产前抑郁患病率为4.4%。年龄≤24岁、教育程度较低（≤12年）、经济状况低或中等、有精神障碍病史、处于孕早期、初产妇、意外怀孕以及未进行孕前筛查的孕妇与产前抑郁相关（均P<0.05）。不同风险水平组的抑郁症状网络显示症状之间存在紧密的相互联系。EPDS8（“悲伤或痛苦”）和EPDS4（“焦虑或担忧”）在不同风险水平组中显示出最高的节点强度。
本研究表明产前抑郁患病率为4.4%。确定了几个社会和产科因素为产前抑郁的风险因素。EPDS8（“悲伤或痛苦”）和EPDS4（“焦虑或担忧”）是减轻产前抑郁负担的临床干预关键靶点。早期识别高危人群对于制定和实施干预策略以提高孕妇整体生活质量至关重要。
