Perinatal depressive symptoms: Five aspects of stability

Abstract Objective: This conceptualized and examined five types of symptom stability: (a) form, (b) prevalence, (c) relative to the group, (d) relative to oneself, and (e) within-person changes. Method: Pregnant women were recruited from outpatient centers of two comprehensive tertiary hospitals in Shandong Province (n = 465). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess perinatal depressive symptoms at six time points: the first, second, and third trimesters and 42 days, three months, and six months postpartum. Results: Symptoms of anxious depression were the most frequent and important to the depression construct during the perinatal period. Across pregnancy, four subtypes of depressive symptoms were identified, with a greater prevalence of depressive symptoms during the second and third trimesters than during the first trimester. Three subtypes of depressive symptoms were identified after delivery, with a higher prevalence at 42 days than that at three and six months. In addition, the depression construct became more coherent, there was an increase in stability relative to oneself and others, along with an increase in within-person stability. Conclusion: The postpartum period is particularly vulnerable. Early interventions to prevent persistent or increased depressive symptoms during the perinatal period may prove promising.