Depression symptoms in Chinese perinatal women: a cross-sectional and longitudinal network analysis

Depression is a common seen mental health concern among perinatal women. This study aims to explore the cross-sectional and longitudinal network structures of depressive symptoms in perinatal women using network analysis, incorporating both directed and undirected approaches. This study employed three types of network analyses to examine the interrelationships among depressive symptoms during early pregnancy, late pregnancy, and postpartum periods: cross-sectional undirected networks, longitudinal undirected networks, and directed acyclic graphs (DAG).We identified the most central symptoms and the causal pathway among symptoms. Network analyses confirmed the stability and reliability of the symptom networks across all examined time points, highlighting "Emptiness" as the predominant central symptom of depression in perinatal women. This centrality was consistently observed across early pregnancy, late pregnancy, and the postpartum period. Directed Acyclic Graphs (DAG) analysis further elucidated "Hopelessness" and "Emptiness" as critical nodes, potentially initiating the cascade of depressive symptomatology. By combining cross-sectional and longitudinal network structures, this study clarifies the central symptoms and potential causal relationships of depressive symptoms in perinatal women, revealing the temporal changes of depressive network structure in perinatal women. This research contributes to better intervention strategies for perinatal depression.