Development trajectories of marital satisfaction and postpartum depression: a longitudinal study

This study aimed to utilize a longitudinal design to delineate the developmental trajectories of marital satisfaction and depressive symptoms in the early postpartum period, examine their longitudinal predictive relationship to examine the directionality, and explore the moderating effects of demographic and obstetric factors on this relationship.

A convenience sampling method was employed to recruit 238 postpartum women from Nantong First People's Hospital between February and August 2025. Participants were assessed at three time points: 1, 6, and 12 weeks postpartum. Data were collected using the Marital Satisfaction Scale and the Edinburgh Postnatal Depression Scale. Data analysis was performed using SPSS 26.0 for descriptive statistics and correlation analysis. Mplus 8.0 was used to construct Latent Growth Models and a Cross-Lagged Panel Model to analyze developmental trajectories and bidirectional predictive relationships.

Developmental Trajectories: Marital satisfaction showed a significant linear declining trend over the 12-week postpartum period; based on linear growth model fitting, postpartum depressive symptoms also exhibited a significant linear increasing trend. Predictive Relationship: Cross-lagged model analysis revealed that earlier marital satisfaction consistently and negatively predicted later levels of depression. However, no significant longitudinal predictive effect of depressive symptoms on marital satisfaction was found, supporting a unidirectional predictive pattern from marital satisfaction to postpartum depression. Moderating Effects: The protective association of marital satisfaction was significantly stronger among unemployed/housewives, those with low monthly household income and those who underwent cesarean section.

This study demonstrates that marital satisfaction is a significant longitudinal protective factor associated with lower levels of postpartum depression, and the strength of this association is moderated by individual socioeconomic resources and health challenges. The findings support integrating the assessment and intervention of marital relationships into postpartum mental healthcare and provide empirical evidence for implementing precise, couple-centered prevention strategies targeting high-risk populations.