Evaluation of presence and severity of depressive symptoms in the prenatal and postnatal period

Objective: This study aimed to determine the presence and severity of depressive symptoms during the prenatal and postnatal periods, evaluate changes in depression according to gestational age, and assess potential risk factors associated with depression. Materials and Methods: This prospective observational study was conducted at Aydın Adnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology. A total of 229 women were included in the study. Participants were divided into two main groups: the pregnancy group (n=137) and the postpartum group (n=92). The pregnancy group was further divided into two subgroups: ≤28 weeks (n=64) and >28 weeks (n=73). The presence and severity of depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Demographic and obstetric characteristics, fetal and maternal factors, and biochemical parameters were recorded. Data were analyzed using SPSS 2020 software. Results: The proportion of individuals with an EPDS score ≥13 was found to be 30,1%. The postpartum group had significantly higher EPDS scores compared to the pregnancy groups (p=0,05). Depressive symptoms were significantly more frequent in the postpartum period than in later stages of pregnancy. There was no significant difference in EPDS scores between the ≤28 weeks and >28 weeks pregnancy groups (p>0,05). However, depression rates were significantly higher in the postpartum period compared to the pregnancy groups (p=0,04). The mean age of participants was 28,9±5,9 years, with the postpartum group having a significantly higher mean age compared to the pregnancy groups (p=0,03). Smoking prevalence was significantly higher in the postpartum group compared to the >28 weeks pregnancy group (p=0,02). A high number of previous pregnancies (gravida) was identified as a significant risk factor for depression (p=0,03). The presence of fetal anomalies showed a strong positive correlation with EPDS scores. Fetal factors were strongly positively correlated with EPDS scores (r=0,65, p<0,001). The rate of fetal anomalies was significantly higher in the postpartum group compared to the pregnancy groups (p=0,03). Similarly, the rate of fetal factors was significantly higher in the postpartum group compared to the pregnancy groups (p=0,03). In terms of maternal factors, the postpartum group had a significantly higher rate of maternal health issues compared to both pregnancy groups (p=0,02-0,05). Vitamin D levels were significantly lower in the postpartum group compared to the ≤28 weeks pregnancy group (p=0,05). A strong negative correlation was found between vitamin D levels and depression (r=-0,061, p<0,001). Conclusion: Prenatal and postnatal depression significantly affect maternal health and are associated with factors such as fetal and maternal factors, low vitamin D levels. Depressive symptoms were observed to be more frequent and severe in the postpartum period. Multivariate analyses identified gravida and the presence of fetal anomalies as the strongest factors associated with high EPDS scores. Early detection of prenatal and postnatal depression and interventions targeting risk factors are crucial for maternal and infant health. Keywords: Prenatal depression, Postnatal depression, Edinburgh Postnatal Depression Scale (EPDS), Pregnancy complications, Maternal mental health.