Antenatal Psychosocial Resources and Obstetric Context Associated with Clinically Diagnosed Postpartum Depression: A Prospective Cohort Study

Background/Objectives: Postpartum depression (PPD) is a clinically important perinatal mental health condition affecting maternal functioning and early mother–infant interaction. Prospective studies using clinically diagnosed PPD outcomes while jointly assessing antenatal psychosocial resources and obstetric context remain limited. This study examined antenatal psychosocial and obstetric factors associated with clinically diagnosed PPD at 6 weeks postpartum. Methods: This prospective cohort study included 85 pregnant women assessed at ≥24 weeks of gestation in a tertiary university hospital. Women receiving psychiatric treatment during pregnancy or meeting DSM-5 criteria for current depressive disorder at baseline were excluded; women with elevated antenatal depressive symptom scores but no current clinical depressive disorder were retained. Antenatal depressive symptoms, perceived stress, perceived social support, psychological resilience, pain catastrophizing, and clinician–patient relational empathy were assessed using standardized measures. Obstetric and neonatal data were extracted from medical records. PPD was assessed at 6 weeks postpartum using a structured DSM-5-based psychiatric interview. Group comparisons, univariable logistic regression analyses, and an exploratory two-domain adjusted logistic regression model were performed. Results: PPD was diagnosed in 25 women (29.4%). Women who developed PPD had higher parity, more frequent maternal obstetric comorbidity, lower infant birth weight and head circumference, higher depressive symptom severity, perceived stress, and pain catastrophizing, and lower perceived social support and psychological resilience. In the exploratory adjusted model, greater perceived social support was associated with lower odds of PPD (adjusted odds ratio [aOR] = 0.58, 95% confidence interval [CI]: 0.35–0.96), whereas higher parity was associated with higher odds (aOR = 2.24, 95% CI: 1.17–4.28). Conclusions: Clinically diagnosed PPD was associated with antenatal psychosocial vulnerability and obstetric context. Antenatal assessment of perceived social support, parity, and broader psychosocial vulnerability indicators may help identify women requiring closer postpartum monitoring.