CHANGES IN CORE DEPRESSIVE SYMPTOMS OVER TIME IN PERIPARTUM WOMEN: A NETWORK ANALYSIS

Abstract Background Perinatal depression (PND) is common in pregnant and postpartum women. Previous research indicates that there are clinical subtypes of PND, and the time of onset is an important factor to identify PND subtypes. However, differences of PND in different trimesters and in the postpartum period are not clear. And studies examining core symptoms that could be used to identify PND subtypes are lacking. Methods Women during the second (N = 161) and third trimesters (N = 248) and within 6 weeks postpartum (N = 110) were recruited. All participants completed the assessment of the Edinburgh Postnatal Depression Scale. Network analysis was used to explore the relationships between depressive symptoms in all three periods. Results Postpartum women showed the highest prevalence of PND and the most severe depressive symptoms. The symptom ‘Sadness and misery’ had the strongest centrality in both the second and third trimesters, but decreased in the postpartum period. The symptom ‘Fear and panic’ had the strongest centrality in the postpartum period. All three PND networks were relatively stable in strength and closeness. Conclusions This study indicated the changes over time in central symptoms in pregnant and postpartum women, which shifted from being dominated by depression to being dominated by anxiety. Our findings suggested that more symptom-specific interventions should be used to improve the mental health of mothers, fetuses and infants. All of this provided clinical evidence to investigate the biological mechanisms of PND subtypes to help diagnose and treat PND with precision.