What question did this study set out to answer?

The study aims to identify patterns of maternal common mental disorders and their associated risk and protective factors in postpartum women during the pandemic.

March 25, 2026Open Access

Typologies of common maternal mental disorders and associated factors: a quantitative life course study applied to cohort data in a resource-constrained setting in Northeastern Brazil

Puntos clave

The study aims to identify patterns of maternal common mental disorders and their associated risk and protective factors in postpartum women during the pandemic.
Prospective cohort study using data from the Iracema-COVID Study
Analyzed maternal mental health using validated instruments across five waves
Employed sequence analyses to identify trajectories of mental disorders
Utilized generalized binomial logistic and log-Poisson regression models for analysis
Identified two main trajectories of maternal common mental disorders: occasional/transitory and mostly/persistent
71.64% of mothers were classified into the occasional/transitory group
Risk factors for persistent CMD trajectory included low education, being single or in a stable union, and longer travel times to healthcare
Living in deprived green areas was associated with higher prevalence of maternal CMDs.

Resumen

Objectives We aim to identify trajectories of probable maternal common mental disorders (CMD), as well as risk and protective factors associated with maternal mental health among postpartum women during the pandemic using life course theory approach. Design Prospective individual level cohort study from the Iracema-COVID Study. Population Mothers (n=335) at postpartum period who delivered during the COVID-19 pandemic in the fourth largest city in Brazil. Methods Probable CMDs were accessed using validated instruments in five cohort waves at postpartum period. Sequence analyses (SA) were employed to extract CMD trajectories, and a set of generalised binomial logistic and log-Poisson multivariable regression models with robust variance were employed to assess risk and protective factors for probable CMDs diagnosis. Outcome measures Trajectories patterns of probable maternal common mental disorders. Results Fit indices demonstrated a two-cluster-SA solution of probable CMD. The patterns of probable CMDs indicated that 335 mothers were clustered into occasional/transitory (n=240, 71.64%) and mostly/persistent (n=95, 28.36%) CMD trajectories. We found that mothers with low education (OR: 2.44; 95% CI 1.13 to 5.23), single (OR: 1.97; 95% CI 1.03 to 3.75) or in a stable union (OR: 2.00; 95% CI 1.02 to 3.90) and travel time spent to access the nearest primary healthcare unit (OR: 1.02; 95% CI 1.006 to 1.04) were associated with increased OR of belonging to the mostly/persistent CMD trajectory. Deprived green areas acted as a risk factor to maternal CMDs prevalence (OR: 1.37; 95% CI 1.002 to 1.87). Conclusions This study provides evidence that individual vulnerabilities and neighbourhood deprivation play an important role in understanding maternal mental health, beyond the patterns and trajectories of probable maternal CMD due to issues confronted during the COVID-19 outbreak in the northeastern region of Brazil. Policies to prevent and treat maternal mental health issues and improvement in neighbourhood deprivation need to be developed and addressed to avoid exacerbation of probable maternal CMDs.

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