The Association Between Self-Reported Acquisition of Perinatal Knowledge and Perinatal Depressive Symptoms: Evidence from the Korean Early Childhood Education & Care Panel Study

Background/Objectives: Postpartum depression is a major public health concern in South Korea, where fertility is among the world’s lowest. We examined whether self-reported acquisition of perinatal knowledge is associated with perinatal depressive symptoms and whether these symptoms are related to intention for a further birth. Methods: We analyzed 3278 women from the nationally representative Korean Early Childhood Education & Care Panel Study, assessed with the Korean Edinburgh Postnatal Depression Scale (K-EPDS; screen-positive ≥ 11) at mid-pregnancy, late pregnancy, one month postpartum and the first annual follow-up (median child age 6 months). Acquisition of perinatal knowledge in four domains was self-reported at that follow-up. Associations were examined with logistic and linear regression and generalized estimating equations. Results: Screen-positive prevalence rose from 10.68% to 28.08% across the four assessments (OR 1.46 per assessment, 95% CI 1.41–1.53). Absence of reported knowledge on maternal–neonatal interaction was associated with screen-positive status in unadjusted analysis (OR 1.47, 95% CI 1.06–2.04) but not after adjustment for antenatal symptoms, social support and sociodemographic covariates (adjusted OR 1.10, 95% CI 0.67–1.80; n = 2037). Social support was inversely associated with screen-positive status (adjusted OR 0.64 per point, 95% CI 0.54–0.76). Among 2236 women with complete data, intention for a further birth was reported by 38.69% of never-symptomatic women, 35.92% with antenatal symptoms only, 28.68% with postpartum-onset symptoms and 23.51% with persistent symptoms (χ2 = 36.40, p < 0.0001). Conclusions: Social support, not reported perinatal knowledge, was independently associated with postpartum depressive symptoms, and postpartum-onset and persistent symptoms were associated with lower intention for a further birth. These findings support screening that begins in pregnancy and continues beyond the early postpartum period, together with strengthening social support; they do not establish that perinatal education prevents depressive symptoms.