Psychometric properties of the Japanese version of the Antenatal Risk Questionnaire–Revised (ANRQ-R): A longitudinal study of postpartum depression risk

Background : Postpartum depression (PPD) necessitates early screening and identification of psychosocial risks. Given the limited availability of validated multidimensional psychosocial risk assessment tools in Japan, this study aimed to cross-culturally adapt and validate the Japanese version of the Antenatal Risk Questionnaire-Revised (ANRQ-R-J). Methods : Pregnant women (N = 1,032; 21–31 weeks’ gestation) completed the ANRQ-R-J (T1). Reliability was assessed through a 2-week retest (N = 194; T2). Predictive validity was evaluated against the Patient Health Questionnaire-9 (PHQ-9) at 1–3 months postpartum (N = 524; T3). Psychometric analyses included internal consistency, concurrent validity, and receiver operating characteristic (ROC) analysis. Results : The ANRQ-R-J, conceptualized as a formative index with non-redundant items, demonstrated acceptable psychometric properties. Although internal consistency was modest (α = 0.62), test–retest reliability was stable (ICC: 0.52–0.75; kappa: 0.40–0.66). Increased endorsement at T2 may reflect culturally influenced patterns of delayed disclosure. ROC analysis showed acceptable discriminative ability (AUC = 0.75). A cutoff score of ≥13 yielded 78% sensitivity and 49% specificity, prioritizing sensitivity for screening purposes. Conclusions : The ANRQ-R-J is a reliable and valid tool for identifying psychosocial risks in Japanese perinatal care. While moderate specificity and online recruitment warrant cautious interpretation, the tool supports early identification and intervention within the Japanese perinatal care system.