Polysocial risk factors and trajectories of antenatal moderate-to-severe depressive symptoms: a retrospective cohort study in Shenzhen, China

作者：Jintao Xiong, Y. Yu, Xuemei Qin, Yilin Peng, Zhuo Peng, Junzhe Cheng, Weiguo Mao, Yan Wang, Yin Guo, Huiqin Li, Mi Wang, Li Zhang, Yumeng Ju, Jing Liu, Minxue Shen, Bangshan Liu, Yan Zhang · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-04290-w · 被引用次数：3 · 研究领域：Maternal Mental Health During Pregnancy and Postpartum、Mental Health Treatment and Access、Gestational Diabetes Research and Management

BACKGROUND: Antenatal depression, especially moderate-to-severe depression, is associated with adverse maternal and infant health outcomes and is affected by multiple psychosocial factors. However, the cumulative effects of psychosocial determinants and trajectories of antenatal depression are underappreciated. This study aimed to investigate the cumulative effects of various psychosocial determinants on antenatal moderate-to-severe depressive symptoms (MSD) based on the polysocial risk score (PsRS), to identify trajectories of MSD based on group-based trajectory modeling (GBTM), and to explore the association between the PsRS and diverse trajectories. METHODS: A retrospective cohort study was conducted among 21,336 pregnant women in Shenzhen, China, from 2020 to 2023. Antenatal depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9) across three pregnancy trimesters. The PsRS was selected and calculated by counting established social determinants from four social risk domains, including socioeconomic status, lifestyle behaviors, psychosocial factors, and living conditions. GBTM was employed to identify distinct trajectories of depressive symptoms. Multinomial logistic regression investigated the relationship between PsRS and diverse trajectories. RESULTS: Of women, 9.1% experienced at least one episode of MSD across three pregnancy trimesters. An intermediate PsRS and a high PsRS were associated with higher risks of MSD during pregnancy, with the adju...