Changes in core depressive symptoms over time in peripartum women: A network analysis

Perinatal depression (PND) is a prevalent mental health condition that affects women during pregnancy and after childbirth. Distinct clinical subtypes of PND exist, with the timing of symptom onset being a pivotal element in the classification of these subtypes. However, the specific manifestations of PND across the various stages of pregnancy and the postpartum period remain to be elucidated. This study aimed to explore the changes in depression symptoms with the stage of pregnancy. Women in their second (n = 161) and third trimesters (n = 248) of pregnancy as well as those in their first 6 weeks of the postpartum period (n = 110) were recruited. Each patient was evaluated using the Edinburgh Postnatal Depression Scale. A network analysis approach was used to explore the interconnections among depressive symptoms across the different time periods. Women in the postpartum period exhibited the most pronounced prevalence of PND and severity of depressive symptoms. In the second and third trimesters, “sadness and misery” was the most central symptom. However, its prominence diminished after childbirth. “Fear and panic” was the predominant symptom in the postpartum network. The structural integrity of PND symptom networks was maintained across all three periods, with consistent strength and closeness. This study demonstrates the temporal evolution of PND’s central symptoms in women during and after pregnancy, transitioning from depression-centric to anxiety-centric manifestations. These findings advocate for symptom-specific interventions to enhance the mental well-being of mothers and their offspring. Furthermore, this study offers clinical insights into the biological underpinnings of PND subtypes, facilitating precise diagnosis and targeted treatment strategies.