Evidence map›Paper›PMID 40745544›Full record

ArticleBMC medicine2025

Polysocial risk factors and trajectories of antenatal moderate-to-severe depressive symptoms: a retrospective cohort study in Shenzhen, China.

Jintao Xiong, Yan Yu, Xuemei Qin, Yilin Peng, Zhuo Peng, Junzhe Cheng, Weiguo Mao, Yan Wang, Yin Guo, Huiqin Li and 7 more

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Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Jintao Xiong *Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Yan Yu *Department of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong, 518100, China.
Xuemei QinDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Yilin PengDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Zhuo PengDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Junzhe ChengDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Weiguo MaoDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Yan WangDepartment of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong, 518100, China.
Yin GuoDepartment of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong, 518100, China.
Huiqin LiDepartment of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong, 518100, China.
Mi WangDepartment of Mental Health Center, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China.
Li ZhangDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Yumeng JuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Jin LiuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China.
Minxue ShenDepartment of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, No. 172, Tongzipo Road, Changsha, Hunan, 410013, China. shenmx1988@csu.edu.cn.
Bangshan LiuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China. bangshan.liu@csu.edu.cn.
Yan ZhangDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, China. yan.zhang@csu.edu.cn.

Funding

Joint Funds of the National Natural Science Foundation of China U23A20434National Key Research and Development Program of China 2021YFF1201204National Natural Science Foundation of China 82171518National Natural Science Foundation of China 82371535Science and Technology Innovation Program of Hunan Province 2023RC3083
6 · The paper itself

Abstract

backgroundAntenatal depression, especially moderate-to-severe depression, is associated with adverse maternal and infant health outcomes and is affected by multiple psychosocial factors. However, the cumulative effects of psychosocial determinants and trajectories of antenatal depression are underappreciated. This study aimed to investigate the cumulative effects of various psychosocial determinants on antenatal moderate-to-severe depressive symptoms (MSD) based on the polysocial risk score (PsRS), to identify trajectories of MSD based on group-based trajectory modeling (GBTM), and to explore the association between the PsRS and diverse trajectories.

methodsA retrospective cohort study was conducted among 21,336 pregnant women in Shenzhen, China, from 2020 to 2023. Antenatal depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9) across three pregnancy trimesters. The PsRS was selected and calculated by counting established social determinants from four social risk domains, including socioeconomic status, lifestyle behaviors, psychosocial factors, and living conditions. GBTM was employed to identify distinct trajectories of depressive symptoms. Multinomial logistic regression investigated the relationship between PsRS and diverse trajectories.

resultsOf women, 9.1% experienced at least one episode of MSD across three pregnancy trimesters. An intermediate PsRS and a high PsRS were associated with higher risks of MSD during pregnancy, with the adjusted hazard ratios being 1.99 (95% CI, 1.71-2.31) and 4.44 (95% CI, 3.81-5.17), respectively, compared with those with a low PsRS. GBTM identified five distinct trajectories of antenatal depressive symptoms: persistent MSD, resolving MSD, chronic mild, resolving mild, and no depressive symptoms. Above all trajectories, persistent MSD demonstrated the highest PSRS scores and risk gradients.

conclusionsThis study provides a practical basis for integrating early polysocial risk screening into routine prenatal care, enabling the timely identification and targeted support of high-risk pregnant women. These findings underscore the need for incorporating comprehensive social risk assessment into maternal health policies and intervention programs to improve mental health outcomes across pregnancy.

Indexed as

DepressionPregnancy ComplicationsAdultChinaFemaleHumansPregnancyRetrospective StudiesRisk FactorsYoung AdultAntenatal depressionGroup-based trajectory modeling (GBTM)Moderate-to-severe depressive symptoms (MSD)Polysocial Risk Score (PsRS)

Identifiers

PMID40745544
PMCPMC12315210

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.