Perinatal mental health across different trimesters of pregnancy and during the postpartum period: trends and risk factors for anxiety and depression

Background: Perinatal mental health is a serious concern, as anxiety and depression affect both mothers and newborns. Nonetheless, only few studies have investigated the changes in symptom patterns across all pregnancy stages and during the postpartum period. This study aimed to assess anxiety and depression at each stage of pregnancy and during postpartum and to identify trimester-specific risk factors. Methods: Pregnant and postpartum women who visited the Department of Obstetrics and Gynecology at Jeju National University Hospital from December 2021 to January 2023 were evaluated. Anxiety and depression were assessed using the Korean versions of the Beck Anxiety Inventory and Edinburgh Postnatal Depression Scale. Participants were categorized into first, second, and third trimesters and postpartum. Results: A total of 445 women were included in the study. During pregnancy, 33.2% and 17.9% of the participants screened positive for anxiety and depression, respectively, at least once. During the postpartum period, 23.6% and 22.9% screened positive for anxiety and depression, respectively. The highest positivity rates for both conditions were observed during the first trimester of pregnancy. Significant risk factors for anxiety and depression in the perinatal period were unemployment, antiemetic drug use, history of thyroid disease, history of miscarriage, preterm premature rupture of membranes, neonatal intensive care unit admission, and adverse neonatal outcomes, including low birth weight. Conclusions: This study highlights the importance of early recognition of mental health risks during pregnancy to enable early intervention and support for affected individuals.