Sociodemographic, obstetric characteristics, antenatal morbidities, and perinatal depressive symptoms: A three-wave prospective study

Objectives: This study aimed (1) to investigate the pattern of perinatal depressive symptoms, and (2) to determine the relationships between sociodemographic characteristics, obstetric factors, antenatal morbidities, postnatal conditions, and perinatal depressive symptoms using a structural equation model (SEM). Method: A three-wave prospective longitudinal design was used for 361 women in their second trimester, third trimester, and at six weeks postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Results: The intensity of depressive symptoms was the highest in the second trimester among the three waves. The SEM showed that unmarried status, unplanned pregnancy, gestational diabetes, and headache were significantly associated with EPDS in the first and second waves. The EPDS in the first wave was able to predict the EPDS in the second and third waves. The SEM has satisfactorily fit with the data (chi-square/degree of freedom = 1.42, incremental fit index = 0.91, Tucker-Lewis index = 0.90, comparative fit index = 0.91, and root mean square error of approximation = 0.03). Conclusion: The findings highlight the significance of monitoring depressive symptoms in the second trimester. Findings from this study could be useful in the design of effective intervention among women with unmarried status, unplanned pregnancy, gestational diabetes, and headache in order to reduce risk of perinatal depressive symptoms.