Psychosocial Factors Associated with a Positive Antenatal Depression Screen: A Cross-Sectional Study of Perception of Motherhood, Attachment Style, Emotional History and Sleep Problems.

Background/Objectives: Identifying pregnant women with heightened emotional vulnerability remains a challenge in antenatal care. A positive screening result is a comparatively infrequent event in clinical samples of moderate size, which complicates the statistical modelling of associated factors. This study aimed to characterise the psychosocial profile associated with a positive antenatal depression screen, integrating attachment style, perception of motherhood, previous emotional history and sleep problems. Methods: A total of 140 women in the third trimester of pregnancy were assessed cross-sectionally using the Edinburgh Postnatal Depression Scale (EPDS), with a threshold of 14 or above defining a positive screen; the Adult Attachment Scale; and single-item psychosocial indicators. Associations were examined using the chi-square test, the Fisher-Freeman-Halton exact test, and Firth penalized logistic regression, chosen to correct the separation arising from the small number of events. Results: The screen was positive in 15.0% of participants. Negative perception of motherhood, anxious-ambivalent attachment, previous emotional history and sleep disturbances were all significantly associated with depressive symptoms; in the multivariable model, only negative perception of motherhood remained independently associated with a positive screen. Conclusions: Structured psychosocial assessment may usefully complement standard EPDS screening in the early identification of antenatal emotional vulnerability.