Factors associated with major stressful life events in a 3-year naturalistic longitudinal screening of perinatal depression.

INTRODUCTION

Stressful life events (SLEs) are common exposures and act as major proximal and distal risk factors for perinatal depression. Pregnancy represents a critical period in which SLE-related psychosocial vulnerability may manifest as depressive symptoms.

AIM: This study investigated the presence of major SLE occurring during pregnancy, and examined their associations with depressive symptomatology, relevant psychological and clinical variables.

METHODS

A multicentre cohort of 2633 women in their third trimester was recruited within a regional perinatal depression screening program and women reporting depressive symptoms were followed postpartum (7 days, 1 month, and 6 months). Longitudinal follow-up assessments were restricted to participants screening positive for depressive symptoms, in accordance with the screening program design. Major SLE were assessed using the Holmes-Rahe Stress Scale, while depressive symptoms, personality, attachment, resilience, coping strategies, and quality of life were all measured with validated instruments.

RESULTS

4.9% (n = 128) of participants experienced major stressful life events (SE ≥150), independent of age, education, employment, or obstetric history. Women exposed to major SLE showed higher baseline and early postpartum depressive symptoms, greater neuroticism, insecure attachment, lower resilience, and poorer quality of life (all p < 0.0001). Major stress exposure was also associated with reduced caregiving support and higher partner psychiatric morbidity. Multivariate analysis identified depressive symptoms, neuroticism, lower psychological wellbeing, absence of a caregiver, and prior perinatal psychopathology as factors independently associated with major stressful life events.

CONCLUSIONS

These findings highlight the need for comprehensive psychosocial screening in perinatal care. Targeted interventions aimed at strengthening resilience, adaptive coping, and relational support may mitigate stress-related risk and prevent perinatal psychopathology.