Maternal perinatal depression (PND), a common mental disorder with a prevalence of
over 10%, is associated with long-term health risks for both mothers and offspring.
This study aimed at describing characteristics related to background and lifestyle,
pregnancy, delivery, and postpartum of different PND trajectories defined according
to the onset of depressive symptoms. Participants were drawn from a large population-based
cohort study in Uppsala, Sweden (n = 2,466). Five trajectory groups of depressive
symptom onset were created using the Edinburgh Postnatal Depression Scale ≥13 (pregnancy)
or ≥12 points (postpartum): (a) healthy (60.6%), (b) pregnancy depression (8.5%),
(c) early postpartum onset (10.9%), (d) late postpartum onset (5.4%), and (e) chronic
depression (14.6%). In multinomial logistic regressions, the associations between
trajectories and the included characteristics were tested using the healthy trajectory
as reference. Background characteristics (younger age, lower education, unemployment)
were primarily associated with pregnancy depression and chronic depression. Characteristics
associated with all PND trajectories were smoking prior to pregnancy, migraine, premenstrual
mood symptoms, intimate partner violence, interpersonal trauma, negative delivery
expectations, pregnancy nausea, and symphysiolysis. Nulliparity, instrumental delivery,
or a negative delivery experience was associated with early postpartum onset. Postpartum
factors (e.g., infantile colic, lack of sleep, low partner support, and bonding difficulties)
were associated with early and late postpartum onset together with chronic depression.
The findings suggest that different PND trajectories have divergent characteristics,
which could be used to create individualized treatment options. To find the most predictive
characteristics for different PND trajectories, studies with even larger and more
diverse samples are warranted.