Moderating effect of dysmenorrhea on the association between number of pregnancies and antenatal depression in the third trimester: a cross-sectional study

To investigate the relationship between third-trimester antenatal depression (AND) and the number of pregnancies, considering the possible moderating role of dysmenorrhea. A total of 1,178 pregnant women in their third trimester were included in this cross-sectional observational study. The pregnant women were categorized into those with and without dysmenorrhea. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), a validated instrument for perinatal depression screening applicable to both antenatal and postnatal populations. Regression analysis and simple slope analysis to evaluate the moderating effect of dysmenorrhea. The non-dysmenorrhea group exhibited significantly higher age, pre-pregnancy BMI, number of pregnancies or deliveries, and lower EPDS scores than the dysmenorrhea group (p < 0.05). In both groups, an inverse relationship was observed between educational levels and EPDS scores (p < 0.001). For the non-dysmenorrhea group, age was inversely related to the EPDS scores (p < 0.001). Within the dysmenorrhea group, the number of Pregnancies and the count of deliveries demonstrated a positive association with EPDS scores (p < 0.001). A negative correlation with EPDS scores was found for both age and the educational levels of the husbands (p < 0.05). Dysmenorrhea was linked to a positive correlation with EPDS scores (p < 0.001). Furthermore, the interaction between the number of pregnancies and the presence of dysmenorrhea also demonstrated a positive correlation with EPDS scores (p < 0.05). In conclusion, there is a significant positive link between the number of pregnancies and AND, with further exacerbation by dysmenorrhea. Dysmenorrhea worsens antenatal depression (AND) in pregnancy. Higher pregnancies/deliveries link to increased AND in dysmenorrhea. Age lowers AND in non-dysmenorrhea group. Dysmenorrhea and pregnancies interact to raise AND risk.