Childhood maltreatment and intimate partner violence as risk factors for joint trajectories of perinatal depression and anxiety.

OBJECTIVE: This study examines joint trajectories of depression and anxiety from pregnancy to three years postpartum. We further investigate whether childhood maltreatment (CM) and intimate partner violence (IPV) predict these trajectories, and how the trajectories are associated with maternal quality of life. METHODS: A cohort of 340 pregnant women was recruited in Hong Kong and assessed at 20-24 weeks gestation, 4 weeks postpartum, and 3 years postpartum. Participants self-reported depressive and anxiety symptoms at each assessment point. At baseline, they retrospectively reported their own history of childhood maltreatment. They also reported their experiences of IPV victimization throughout the study period, and quality of life at the 3 years postpartum. Distinct joint trajectories of depression and anxiety were analyzed using the parallel-process latent class growth analysis. Logistic and linear regressions were employed to examine key factors of trajectories and associations with quality of life, respectively. RESULTS: Three distinct joint trajectories emerged: a Resilience group characterized by consistently low depression and anxiety symptoms (76.2%), a Recovery group characterized by initially elevated but decreasing symptoms (18.5%), and a Relapsing group characterized by symptoms that decreased after childbirth but increased again at 3 years postpartum (5.3%). Higher CM increased the likelihood of belonging to the Recovery (OR = 1.46, p<0.01) or Relapsing groups (OR = 2.09, p<0.001) compared to the Resistance group after adjusting key confounders. IPV during pregnancy was associated with the Relapsing trajectory (OR = 2.77, p<0.05) in the unadjusted models. Women in the Relapsing group reported significantly lower mental (β = -0.32, p<0.001) and physical (β = -0.19, p<0.001) quality of life at 3 years postpartum adjusting key confounders. CONCLUSIONS: Regular screening for depressive and anxiety symptoms from pregnancy through the postpartum period is essential. Identifying distinct symptom trajectories and their risk factors, such as CM and IPV, is crucial for providing targeted interventions to women at greater risk.