Psychosocial characteristics and daily impairment in women with persistent perinatal depressive symptoms: A large-scale cohort study

Background: This study aimed to determine the prevalence of persistent perinatal depressive symptoms and to identify the psychosocial characteristics associated with persistent symptoms among Japanese women. While persistent perinatal depression significantly impact both mothers and children, evidence from Japan remains limited. Methods: A longitudinal online survey was conducted at three time points: during pregnancy, 1-month postpartum, and 6-month postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), and daily impairment was measured using the difficulty item of the Patient Health Questionnaire-9. The EPDS cutoff score was 13 during pregnancy and 9 for postpartum. Group differences were examined using chi-square tests and one-way ANOVAs, followed by multivariable logistic regression. Results: Among the 1039 participants (31.85±4.31 years), those who scored over cutoff during pregnancy, 1-month postpartum, and 6-month postpartum were 9.5%, 12.5%, and 11.3%, respectively. Depressive symptoms remained consistently high at all three-time points for 41 women (3.9%), fluctuated for 238 (22.9%), and remained low for 760 (73.2%). Persistent perinatal depressive symptoms were associated with greater daily impairment and were predicted by lower household income, personal psychiatric history, fewer sleeping hours at 1-month postpartum, and fear of COVID-19. Limitations: Data were self-reported via the internet, and daily impairment was assessed using a single item. Conclusions: Persistent perinatal depressive symptoms are associated with greater daily impairment and specific psychosocial vulnerabilities. Given their potential adverse effects on both mothers and children, continuous monitoring and support for depressive symptoms throughout the perinatal period are essential from a public health perspective.