Maternal depression over 7 years postpartum: trajectories and multidimensional predictors in a longitudinal cohort study

TL;DR

This study tracks maternal depression over 7 years and identifies risk factors like prenatal depression and family stress.

Contribution

The study reveals long-term maternal depression trajectories and multidimensional predictors in a longitudinal cohort.

Findings

55.6% of mothers experienced mild-to-moderate or severe depressive symptoms at some point.

Preterm delivery, prenatal depression, and marital conflict are significant predictors of depressive symptoms.

Higher education is a protective factor against long-term depressive symptoms.

Abstract

Maternal depression can persist beyond the immediate postpartum period and can adversely affect maternal functioning and child development. However, evidence describing long-term trajectories and multidimensional predictors remains limited. This study investigated the 7-year trajectory of maternal depressive symptoms from childbirth to when the child reached 6 years of age and identified significant predictors across child, maternal, and family domains.

In total, 1,030 mothers from the Panel Study on Korean Children were included. Depressive symptoms were assessed at postpartum years 1, 3, 5, and 7 using the Kessler Depression Scale. Latent growth modeling was used to examine symptom trajectories, and logistic regression analyses were conducted to identify predictors of depressive-symptom risk.

Overall, 55.6% of mothers experienced at least one episode of mild-to-moderate or severe depressive symptoms. Among at-risk mothers, depressive symptoms demonstrated a slight upward trajectory with significant individual variability (linear model fit: χ2=12.65, root mean square error of approximation=.05, comparative fit index=.96). Significant predictors included preterm or low-birth-weight delivery (odds ratio [OR]=2.29), prenatal depression (OR=2.61), postpartum depression at 1 month (OR=3.41), high parenting stress (OR=1.63), low self-esteem (OR=2.33), and marital conflict (OR=2.02). Higher educational attainment emerged as a protective factor (OR=0.59).

These findings demonstrate the persistence of maternal depressive symptoms and highlight key predictors for promptly identifying mothers at elevated risk. Integrating routine longitudinal screening with interventions targeting maternal stress, self-esteem, and family functioning may be critical for mitigating long-term depressive trajectories. Family-centered approaches, including partner involvement and conflict-management strategies, appear essential for improving maternal mental health and promoting healthier developmental environments for children.

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