Maternal and Paternal Depression During Pregnancy in China: Prevalence, Correlates, and Network Analysis

Zhang, Yongfu; Sun, Hengwen; Li, Wengao; Luo, Xian; Liu, Ting; Fang, Fan; Xiao, Julan; Garg, Samradhvi; Yang, Yuan; Chen, Yu

BACKGROUND: Depression is a commonly seen mental health concern for mothers and fathers during their transition to parenthood. This study aims to provide new insights into the prevalence of maternal and paternal depression, its demographic and clinical correlates, and its symptom network among Chinese pregnant women and their partners. METHODS: In this multicenter, cross-sectional study, 769 pregnant women and their partners were assessed by Edinburgh Postnatal Depression Scale (EPDS) from June 15th to Sep 15th, 2020 in southern China. Convenient sampling method was used. Univariate analyses, multivariate logistic regression, and network analyses were conducted. Networks of maternal and paternal depression were compared. RESULTS: In total, 60 (EPDS total score ≥13, 7.80%, 95% CI: 5.90–9.70%) women and 23 (2.99%, 95% CI: 1.78–4.20%) of these women’s partners reported depression. Physical comorbidities (OR=2.664, P=0.003) was the only factor that was found to significantly correlate with maternal depression. Network analyses showed that the resulting networks were well connected and that there was significant difference of network structure between maternal and paternal depression (M=0.330, P<0.001). Centrality plot indicated that “sad or miserable” (strength=1.097) was the most central symptom in the maternal depression network, while “scared or panicky” (strength=1.091) was the most central node in the paternal network. The edge between “things have been getting on top of me” – “able to laugh and see the funny side of things” (difference: 0.153, P=0.020), and “scared or panicky” – “the thought of harming myself” (difference: 0.084, P<0.001) was significantly stronger in women’s partners than that in pregnant women. CONCLUSION: Maternal and paternal depression during pregnancy could result in significant negative consequences. Symptoms like “sad or miserable” and “scared or panicky” are critical and might be potential targets for further interventions. Evidence-based treatments, such as pharmacology, psychotherapy, community reinforcement and family training, might be beneficial for parents with depression during and after the pregnancy.