Temporal transition patterns and predictors of depressive symptoms during pregnancy: A latent transition analysis

Background: Antenatal depression is a critical factor affecting maternal health. However, the heterogeneous profiles of antenatal depression across pregnancy, the evolving patterns of profile transitions over time, and their predictors remain unclear. This study aims to identify the latent profiles of antenatal depressive symptoms in pregnant women, analyze the developmental patterns of risk type transitions over time, and explore key predictors of the probabilities of profile transitions during pregnancy. Methods: A longitudinal follow-up study was conducted in two cities in China, involving 856 pregnant women who met the inclusion criteria and completed surveys during early, mid, and late pregnancy. Data were analyzed using Latent Profile Analysis (LPA) and Latent Transition Analysis (LTA). LPA was employed to identify latent profiles of antenatal depression, while LTA was used to explore longitudinal patterns of profile transitions from early to late pregnancy. Regression mixture models and logistic regression analyses were applied to examine the associations between demographic characteristics, family functioning, and the distinct latent profiles of antenatal depression as well as their developmental transitions. The Harman single-factor test was used to assess common method bias. Results: Antenatal depression demonstrates developmental heterogeneity across pregnancy and can be categorized into four distinct subgroups. Latent Transition Analysis (LTA) revealed that pregnant women in the low depressive symptom group were more likely to remain stable over time, with a stability probability of 86 %. In contrast, those in the high depressive symptoms group showed a higher likelihood of transitioning (20 %), with probabilities of shifting to the moderate anhedonia group and the low anhedonia group both at 32 %. Educational attainment, physical activity, and family functioning were identified as significant predictors of antenatal depression profiles (P < 0.01). Furthermore, age, educational level, residence, employment status, physical activity, and family functioning were significant predictors of the transition probabilities between antenatal depression profiles over time (P < 0.01). Conclusion: The latent profiles of antenatal depressive symptoms exhibit relatively stable transition patterns throughout pregnancy. Education level, physical activity, and family functioning are significant predictors of these profiles and their transition probabilities over time. The impact of prenatal depression on maternal and offspring health poses not only short-term threats but also long-term multidimensional health burdens. Comprehensive early screening for depressive symptoms, combined with continuous and personalized intervention strategies tailored to prenatal depression profiles, should be integrated into standard prenatal care.