Emotion regulation is robustly associated with depressive symptoms across the peripartum – data from a prospective Swedish national cohort study

Peripartum depression (PeriPD) has serious consequences for mothers and children, yet early detection is challenging. Emotion regulation (ER) is increasingly recognized as a key factor for maternal mental health, however, associations with depressive symptoms during the peripartum remain insufficiently understood. In this prospective, population-based Swedish cohort study (N = 623), we examined whether ER difficulties in the second trimester, assessed via the Difficulties in Emotion Regulation Scale-16 (DERS-16), are associated with depressive symptoms across seven peripartum timepoints using the Edinburgh Postnatal Depression Scale. Higher ER difficulties were significantly associated with elevated depressive symptoms during pregnancy to 14–23 weeks postpartum, independent of confounders. ER difficulties also differed between PeriPD trajectories, with higher scores in early- and late-postpartum-onset groups. These findings highlight second trimester ER as a robust vulnerability marker for PeriPD, with the DERS-16 offering potential for early risk detection. Targeting ER may provide a promising strategy for mitigating peripartum mental health risks.