Association between trajectories of maternal depressive symptoms and length of hospital stay, hospitalization costs, and adverse maternal and infantile outcomes: A longitudinal observational study

Author:

Sun Jiwei1ORCID,Cui Naixue1,Shao Di2,Li Jie2,Zhang Huihui3,Li Jiahuan4,Zhang Xuan1,Cao Fenglin1ORCID

Affiliation:

1. School of Nursing and Rehabilitation Cheeloo College of Medicine Shandong University Jinan Shandong China

2. School of Public Health Cheeloo College of Medicine Shandong University Jinan Shandong China

3. Qilu Hospital of Shandong University Jinan Shandong China

4. School of Health and Nursing Zhenjiang College Zhenjiang Jiangsu China

Abstract

AbstractThis study aimed to determine the trajectories of perinatal depression and their relationship with length of hospital stay (LOS), hospitalization costs, and adverse maternal and infantile outcomes. This longitudinal observational study included 525 participants. Perinatal depressive symptoms were assessed at four waves (from the first trimester to the postpartum period). LOS, hospitalization costs, and adverse maternal (sleep, fatigue, anxiety, perceived stress, and memory problems) and infantile outcomes of participants were obtained from medical records and self‐reported questionnaires. Trajectories of perinatal depressive symptoms were explored with latent class growth analysis. Associations between trajectories and adverse maternal and infant outcomes were explored with multiple linear regression and binary logistic regression models. The participants' average age was 29.6 ± 3.9 years. Five heterogeneous developmental trajectories of perinatal depressive symptoms were identified as follows: high‐level (7.05%), moderate‐increasing (12%), remission (15.05%), moderate‐level (37.14%), and low‐level (28.76%). The average LOS was 5.78 ± 2.13 days, and the average hospitalization costs were 12,695.27 ± 5457.51 yuan. Compared with the trajectory of low‐level depressive symptoms, the LOS, hospitalization costs, and likelihood of adverse outcomes of women with high‐level and moderate‐increasing depressive symptom trajectories increased. The findings capture the heterogeneity of perinatal depression in Chinese women. Women in the moderate‐increasing and high‐level trajectory groups had longer LOS, more hospitalization costs, and poor birth outcomes. Elucidating the trajectories of perinatal depression and their relationship with maternal and infant health outcomes provides important insights into the development of person‐centred care planning for women during pregnancy and postpartum.

Funder

National Natural Science Foundation of China

Natural Science Foundation of Shandong Province

Publisher

Wiley

Subject

Psychiatry and Mental health,Applied Psychology,Clinical Psychology,General Medicine

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