Prevalence, risk factors and family dynamics of antenatal depression in couples: A multicenter cross-sectional study.

BACKGROUND

Parental depression during the perinatal period is a public health concern. This study aims to evaluate the prevalence of antenatal depression in couples, identify associated risk factors, and examine family dynamics, particularly marital and in-law relationships.

METHODS

A cross-sectional, multicenter study conducted from November 2023 to June 2024 surveyed 2460 pregnant women and their partners in Anhui Province, China. The Edinburgh Postnatal Depression Scale (EPDS) was used for psychological assessment. Logistic regression identified risk factors for antenatal depression, and structural equation modeling (SEM) examined the direct and indirect effects of family relationships on antenatal depression.

RESULTS

The prevalence of comorbid antenatal depression within couples was 3.3 %, with similar rates in women (16.4 %) and men (14.6 %). Key risk factors for both maternal and paternal depression included marital distress, unexpected pregnancy, a personal history of depression, and partner depressive symptoms. Additional risk factors for women were mother-in-law relationships, lower education, and lower household income. SEM analysis revealed that mother-in-law relationships had a direct effect on both marital distress (β = 0.69, p < 0.001) and depression in women (β = 0.15, p < 0.001). Furthermore, the indirect effect of mother-in-law relationships on maternal depression (β = 0.12, p < 0.001) was significantly stronger than that on paternal depression (β = 0.02, p < 0.001).

CONCLUSION

Maternal and paternal mental health during the perinatal period should be prioritized, especially in the presence of marital and in-law stressors. A family-centered care model with targeted psychological support may help mitigate antenatal depression.