Differences in postpartum depressive symptoms across survey waves among Chinese mothers and their association with structural resources: a repeated cross-sectional study based on CFPS data

Using China Family Panel Studies data (CFPS; 2016, 2018, 2020, and 2022), this study examined between-sample differences in postpartum depressive symptoms across survey waves in China and their association with structural resources.

This repeated cross-sectional study included 827 mothers living in households with 0-year-old infants, identified by linking child questionnaires, family relationship files, and adult questionnaires. Depressive symptoms were measured using the CES-D total score. Elevated depressive symptoms were defined as CES-D ≥ 36, approximately corresponding to the conventional CES-D ≥ 16 cutoff. Structural resources were measured using an index based on educational attainment, employment status, and urban-rural residence. Descriptive statistics, multiple linear regression, binary logistic regression, and sensitivity analyses were conducted.

Mean CES-D scores across the four survey-wave samples were 32.1 ± 7.0, 32.8 ± 6.3, 32.8 ± 7.7, and 34.2 ± 8.4. The proportions with elevated depressive symptoms were 25.3, 28.5, 27.4, and 31.4%. In fully adjusted models, the 2022 sample had higher CES-D scores (β = 3.02, SE = 0.99, p = 0.002) and higher odds of elevated depressive symptoms (OR = 2.56, 95% CI: 1.33-4.92, p = 0.005) than the 2016 sample. The structural resource index was negatively associated with elevated depressive symptoms (OR = 0.88, 95% CI: 0.77-1.00, p = 0.046), but this association was attenuated under a stricter threshold.

Postpartum depressive symptoms differed across CFPS survey-wave samples. Higher structural resources were modestly associated with lower odds of elevated depressive symptoms.