Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors

Arch Womens Ment Health. 2018 Dec;21(6):689-698. doi: 10.1007/s00737-018-0845-y. Epub 2018 Apr 13.


The aim of this study is to identify subgroups of women who exhibit distinct trajectory patterns of depressive and anxiety disorders from pregnancy to early postpartum and the risk factors associated with the latent trajectory group memberships. Women (n = 615) from the Feelings in Pregnancy and Motherhood (FIP) longitudinal study were followed from early pregnancy to early postpartum for a 7-month period in 2006-2007. The semi-parametric group-based trajectory modeling approach was used to identify the latent trajectory groups. Multinomial logit models were then used to explore the association between latent trajectory group membership and antenatal characteristics. We identified four latent trajectory groups of perinatal depressive symptoms: "low-stable" (49.6%), "moderate-stable" (42.3%), "postpartum" (3.6%), and "antepartum" (4.6%). Significant risk factors associated with these trajectory group memberships were past depression, stress level, ethnicity, the mother's age, and relationship satisfaction. Three latent trajectory groups of perinatal anxiety symptoms were identified: "very low-stable" (8.9%); "low-stable" (60.7%); and "moderate-stable" (30.4%). Significant risk factor associated with these trajectories were past depression, stress level, and income level. Latent trajectory groups of perinatal depressive and anxiety symptoms were identified to uncover potential heterogeneity in populations. Our findings support the need for multiple assessments starting from early pregnancy to the postpartum, which can give some important insights on the characteristics of the women at high symptom burden trajectories for early interventions that may alter the progress of their mental symptoms.

Keywords: Group-based trajectory analysis; Longitudinal trajectories; Mood disorders; Perinatal anxiety; Perinatal depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders* / diagnosis
  • Anxiety Disorders* / psychology
  • Canada / epidemiology
  • Depression, Postpartum* / diagnosis
  • Depression, Postpartum* / epidemiology
  • Depression, Postpartum* / psychology
  • Depressive Disorder* / diagnosis
  • Depressive Disorder* / epidemiology
  • Depressive Disorder* / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Mothers / psychology
  • Postpartum Period / psychology
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / epidemiology
  • Pregnancy Complications* / psychology
  • Pregnant Women / psychology
  • Prognosis
  • Psychiatric Status Rating Scales
  • Risk Assessment / methods
  • Risk Factors
  • Stress, Psychological* / diagnosis
  • Stress, Psychological* / epidemiology
  • Stress, Psychological* / etiology
  • Stress, Psychological* / psychology