Socio-contextual vulnerability and postpartum depressive symptomatology: A latent class analysis

To identify latent classes of socio-contextual vulnerability among postpartum women and to examine whether these classes differed in postpartum depressive symptomatology and self-reported postpartum depression diagnosis. A total of 1308 women residing in Spain who had given birth within the previous 24 months participated in this cross-sectional online study. Latent class analysis (LCA) was conducted based on socio-demographic, caregiving, contextual, obstetric, and prior clinical-history indicators, including employment status, educational attainment, caregiving support, area of residence, age, partnership status, primiparity, postpartum time, and previous depression history. Differences between classes in EPDS screening positivity and self-reported postpartum depression diagnosis were subsequently explored. A 2-class model with better fit, parsimony, and interpretability was selected. The identified classes were characterized as Class 1: Higher socio-contextual vulnerability (27.5%) and Class 2: Lower socio-contextual vulnerability (72.5%). Relative to Class 2, Class 1 showed lower probabilities of employment (0.443 vs. 0.926) and higher education (0.482 vs. 0.833), together with higher probabilities of low caregiving support (0.392 vs. 0.132), unemployment (0.271 vs. 0.029), caregiving or home duties (0.248 vs. 0.038), younger age (0.666 vs. 0.443), and rural residence (0.288 vs. 0.122). Women in the higher socio-contextual vulnerability class showed a higher probability of EPDS screening positivity (0.632 vs. 0.551; OR = 1.401, 95% CI [1.163, 1.672]) and a somewhat higher probability of self-reported postpartum depression diagnosis (0.143 vs. 0.116). The findings suggest that postpartum depressive symptomatology is embedded within broader socio-contextual conditions and support the importance of incorporating socio-contextual indicators into postpartum mental health screening and prevention strategies.