Joint Developmental Trajectories of Perinatal Depression and Anxiety and Their Predictors: A Longitudinal Study

Background: Perinatal depression and anxiety can be experienced simultaneously and change over time. This study aimed to explore the independent and joint developmental trajectories and predictors of perinatal depression and anxiety. Methods: From January 2022 to December 2023, a total of 1062 pregnant women from Affiliated Women's Hospital of Jiangnan University were surveyed for depression and anxiety symptoms using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) in early pregnancy (T1, 0-13⁺⁶ weeks), mid-term pregnancy (T2, 14-27⁺⁶ weeks), late pregnancy (T3, 28-41 weeks), and 42 days postpartum (T4). Parallel-process latent class growth model (PPLCGM) was performed to identify the joint developmental trajectories of perinatal depression and anxiety, and logistic regression was used to analyze factors of joint trajectories. Results: Perinatal depression and anxiety each showed four heterogeneous developmental trajectories, and three joint developmental trajectories were identified: "high-slightly decreasing depression and high decreasing anxiety group" (3%), "low-stable depression and low-stable anxiety group" (71%), and "moderate-slightly increasing depression and moderate-decreasing anxiety group" (26%). Adverse maternal history, history of anxiety and depression, and work stress were risk factors for the joint developmental trajectory of perinatal depression and anxiety, while regular exercise, paid work and social support were protective factors. Conclusions: Three joint developmental trajectories for perinatal depression and anxiety were identified, demonstrating group heterogeneity. Perinatal healthcare providers should pay attention to the mental health history of pregnant women, conduct multiple assessments of perinatal anxiety and depression, prioritize individuals with risk factors, and advocate for regular exercise, work participation, and provide greater social support.