Associations between maternal lipid metabolism in early pregnancy and postpartum symptoms of depression and anxiety: results from a longitudinal cohort of 266 women

Background The COVID-19 pandemic has exacerbated psychological vulnerability in perinatal women. Emerging evidence suggests a link between systemic inflammation, lipid metabolism, and mental health. This study aims to evaluate whether first-trimester lipid profiles can predict postpartum depression (PPD) and anxiety in the post-pandemic context. Methods A prospective cohort study of 266 pregnant women was conducted. Fasting lipids (Triglycerides, HDL, LDL) were measured at the 12th week of gestation. Mental health was assessed at 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI). Results 22.6% of women exhibited PPD symptoms (EPDS > 12). High first-trimester triglycerides (TG) and an elevated TG/HDL ratio (≥ 1.9) were significantly associated with higher EPDS scores (p < 0.001). Multivariable regression confirmed the TG/HDL ratio as an independent predictor of PPD (Adjusted OR 1.65; 95% CI 1.22–2.10). Conclusions Early pregnancy lipid profiles show significant prospective associations with postpartum psychological distress, suggesting their potential role as early screening candidates that require further validation.