Group-Based Trajectory Analysis for Postpartum Depression Symptoms among Chinese Primiparous Women


Postpartum depression (PPD) is a common medical condition that affects women after giving birth. It is a type of depression that can occur within the first year after delivery, although it usually begins within the first three months. PPD can present in a range of symptoms including persistent feelings of sadness, loss of interest in activities once enjoyed, fatigue, changes in appetite, and sleep disturbances. Other signs may include feelings of hopelessness, guilt, worthlessness, difficulty concentrating, and suicidal thoughts. The causes of PPD are not fully understood, but it is thought to be linked to hormonal changes that occur during pregnancy and after birth. Other factors such as a history of depression, stressful life events, lack of social support, and a difficult pregnancy or birth experience may also contribute to PPD. It is important for healthcare providers to screen for PPD during routine postpartum visits and to refer patients to appropriate resources if they are experiencing symptoms. Treatment options may include therapy, medication, and support groups. In addition, lifestyle changes such as exercise, healthy eating, and getting enough sleep can also be beneficial. PPD can have a significant impact on the well-being of new mothers, as well as their families. As a doctor, it is essential to provide education and support to patients to promote early recognition and treatment of PPD. With appropriate treatment and support, most women with PPD can recover and go on to enjoy motherhood.

PPD is estimated to affect up to 15% of people who give birth worldwide, but the prevalence and trajectory of PPD symptoms may vary across different populations and cultures. Therefore, it is important to understand the patterns and predictors of PPD symptoms in different contexts. One such context is China, where PPD is a significant public health concern. China has the largest population of people who give birth in the world, with about 15 million births per year. Primiparous people may be more vulnerable to PPD due to the lack of experience and support in coping with the challenges of parenthood. Additionally, the migration of young people from rural to urban areas for education and employment opportunities has resulted in increased geographic distance and reduced social support from extended family members. Group based trajectory model (GBTM) is a statistical method that aims to identify distinct subgroups of individuals or units that follow similar patterns of change over time in a multivariate outcome variable. GBTM assumes that the population is heterogeneous and composed of a finite number of latent groups, each with a different underlying trajectory. GBTM estimates the number and shape of the trajectories, as well as the probability of group membership for each individual or unit.

In a new research published in Journal of Clinical Medicine, Dr. Juan Xiong, Ms.Qiyu Fang, Ms.Lingling Huang, Ms. Xinyi Yan and Dr. Xujuan Zheng from Shenzhen University in collaboration with The University of Hong Kong identified the subgroups of Chinese primiparous women that have different patterns of postpartum depression symptoms over the first six months postpartum, and examined the factors that predict their membership in these subgroups.

Authors wanted to see how different groups of women from China felt sad or depressed after having their first baby. They used a special way to find four groups that had different levels of sadness or depression for the first six months after giving birth. Researchers gave names to the four groups: “few or no symptoms”, “subclinical but present symptoms”, “minor PPD status”, and “major PPD status”. The number of women in each group was 18%, 32%, 31%, and 19%, in that order. The average sadness or depression scores of each group changed over time, with the “major PPD status” group having the highest scores and the “few or no symptoms” group having the lowest scores. They also looked at what things made women more likely to be in one group or another. Investigators found that having less help and support from others and not learning how to be a good parent were linked to higher chances of being in the “minor PPD status” and “major PPD status” groups than in the “few or no symptoms” group. These results show that almost half of the new mothers from China inthis study felt some to a lot of sadness or depression after having their first baby, and that having more help and support from others and learning how to be a good parent are important things for stopping and helping sadness or depression after giving birth.

In conclusion, the authors reported that postpartum depression symptoms vary among different groups of Chinese women who had their first baby. They identified four groups with different levels of sadness or depression and their predictors. Authors suggest that more social support and parenting training are needed to prevent and treat postpartum depression among new mothers in China.


Xiong J, Fang Q, Huang L, Yan X, Zheng X. Group-Based Trajectory Analysis for Postpartum Depression Symptoms among Chinese Primiparous Women. Journal of Clinical Medicine. 2022 ;11(21):6249.

Go To Journal of Clinical Medicine.