Cross-lagged panel model of depressive mood and influencing factors in high-risk perinatal depression

While research has uncovered intricate relationships between cognitive reactivity (CR), sleep quality, perceived stress, family function, mindfulness, and perinatal depression (PND), their temporal dynamics remain unclear. Previous studies have focused primarily on cross-sectional analyses or single-time-point associations and lack longitudinal exploration of the bidirectional relationships and temporal precedence between these variables.

The study was conducted in Fujian Province, China, from December 2021 to January 2023. A cross-lagged panel model was used to examine the temporal relationships among CR, sleep quality, perceived stress, family function, mindfulness, and PND in pregnant women at high risk for depression. A total of 329 participants completed a baseline questionnaire during the third trimester (T1) and completed follow-up assessments three months postpartum (T2). Standardized scales were used to measure key variables. Statistical analyses were performed using IBM SPSS 26 and R 4.2.3 software, with the "lavaan" package employed for cross-lagged panel model construction.

The findings revealed that the relationship between CR and depression among women at high risk of PND persisted over time due to autoregressive effects. PND at T1 was prospectively associated with changes in CR, family function, perceived stress, mindfulness, and sleep quality at T2 ( B = 2.467, -0.473, 0.878, -0.306, 0.393, P < 0.05). However, the cross-lagged effects of CR, family function, mindfulness, and sleep quality at T1 on the PND total score at T2 were not significant. The only exception was the significant positive cross-lagged effect of perceived stress at T1 on PND at T2. ( B = 0.102, P < 0.05).

This study among high-risk women with PND found that late-pregnancy depression was prospectively associated with higher postpartum cognitive reactivity, perceived stress, and depressive symptoms, and with poorer family function, mindfulness, and sleep quality. These findings advance understanding of the dynamic interplay between perinatal psychological and interpersonal factors and highlight the need for early intervention during pregnancy. Clinically, strengthening depression screening and adopting targeted strategies-such as cognitive-behavioral therapy, family counseling, mindfulness training, and sleep optimization-may aid in the prevention, early detection, and treatment of PND, thereby safeguarding maternal mental health and infant well-being.