Influencing factors of postpartum depression, anxiety, and comorbid conditions among Chinese women: A prospective study

Abstract

Objective: To examine the changes in depression, anxiety, and comorbid anxiety and depression, which are common during the perinatal period, and to explore the influencing factors of these conditions among perinatal women. Methods: This prospective study recruited pregnant women from three tertiary hospitals in Nantong City, China. Overall, 635 participants completed self-reported measurements during the third trimester and at 6 weeks postpartum. The main postpartum outcome measures were depression, anxiety, and comorbid anxiety and depression. Statistical data were expressed using percentages; χ2 test and a disordered multiple classification logistic regression model were required. Results: The incidence of postpartum depression, anxiety, and comorbidity were lower 6 weeks postpartum than during the third trimester. Postpartum women were divided into four groups according to their depression and anxiety levels. The three most important factors affecting the four postpartum groups' classification were postpartum stress, resilience, and prenatal anxiety. Compared with women without postpartum depression, anxiety, and comorbidity, stress, sleep quality, and resilience were found to be influencing factors of depression, anxiety, and comorbidity. Age, prenatal anxiety, and comorbidity influenced postpartum anxiety and comorbidity. Marital satisfaction affected postpartum comorbidity, and breast pain affected postpartum anxiety. Conclusion: Postpartum women's negative emotions are affected by prenatal negative emotions and postpartum-related factors. Given the identified risk factors for postpartum depression, anxiety, and comorbid conditions, future research should focus on testing proactive, targeted, early-intervention strategies during pregnancy to determine their effectiveness in reducing women's negative postpartum emotions.