Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents

Using K-means clustering and item response theory analyses, the authors identified 3 stable trajectory groups—low, mild, and high symptom levels—consistently across all 7 cohorts. A subgroup analysis of women meeting clinically validated cutoffs for probable depression (EPDS ≥15 during pregnancy and/or ≥13 postpartum) also displayed a stable trajectory over the perinatal period. The study was limited by the exclusion of individuals using psychotropic medications in some cohorts, the absence of cohorts from low- and middle-income countries, and a predominantly White participant sample, though the same trajectories were found in ethnically diverse Singapore cohorts. Findings support the early antenatal period as the optimal timing for identification and intervention.