Gao YP, Lu YY. Time series analysis of anxiety and depression during pregnancy to postpartum depression based on cross-lagged model. World J Psychiatry 2026; 16(2): 113533 [DOI: 10.5498/wjp.v16.i2.113533]
Corresponding Author of This Article
Yu-Yan Lu, Department of Obstetrical, Suzhou Ninth People’s Hospital, No. 2666 Ludang Road, Taihu New Town, Wujiang District, Suzhou 215200, Jiangsu Province, China. 15250193830@163.com
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Psychology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 19, 2026 (publication date) through Feb 2, 2026
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World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Gao YP, Lu YY. Time series analysis of anxiety and depression during pregnancy to postpartum depression based on cross-lagged model. World J Psychiatry 2026; 16(2): 113533 [DOI: 10.5498/wjp.v16.i2.113533]
World J Psychiatry. Feb 19, 2026; 16(2): 113533 Published online Feb 19, 2026. doi: 10.5498/wjp.v16.i2.113533
Time series analysis of anxiety and depression during pregnancy to postpartum depression based on cross-lagged model
Yi-Ping Gao, Yu-Yan Lu
Yi-Ping Gao, Yu-Yan Lu, Department of Obstetrical, Suzhou Ninth People’s Hospital, Suzhou 215200, Jiangsu Province, China
Author contributions: Gao YP contributed to the conception, design, writing, review, and revision of the manuscript; Gao YP and Lu YY contributed to the analysis and interpretation of data. All authors contributed to the acquisition of data, acquired and managed patients, and final approved the manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Suzhou Ninth People’s Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Yan Lu, Department of Obstetrical, Suzhou Ninth People’s Hospital, No. 2666 Ludang Road, Taihu New Town, Wujiang District, Suzhou 215200, Jiangsu Province, China. 15250193830@163.com
Received: October 10, 2025 Revised: November 4, 2025 Accepted: December 4, 2025 Published online: February 19, 2026 Processing time: 111 Days and 22.7 Hours
Abstract
BACKGROUND
Women are susceptible to anxiety and depression during pregnancy, but the temporal patterns of these emotions across gestation remain unclear. It is also uncertain whether anxiety and depression during pregnancy exert time-lagged effects on postpartum depression.
AIM
To explore the dynamic trends of anxiety and depression at different stages of pregnancy and their time-lagged effects on postpartum depression, providing a reference for emotional management during and after pregnancy.
METHODS
Data were collected from 572 women who underwent prenatal care and delivered at the Obstetrics Department of Suzhou Ninth People’s Hospital between January 2024 and June 2025. The χ2 test was used to assess psychologically changes from early to late pregnancy. Pearson partial correlation and cross-lagged modeling were used to examine temporal relationships between prenatal anxiety/depression and postpartum depression.
RESULTS
Anxiety detection rates were 6.99% (40/572) in early pregnancy, 24.13% (138/572) in midpregnancy, and 16.96% (97/572) in late pregnancy, showing a significant fluctuation trend (χ2 = 21.092, P < 0.001). Depression rates were 5.42% (31/572), 21.68% (124/572), 13.81% (79/572) and 16.08% (92/572) in early, mid, late pregnancy, and six weeks postpartum, respectively, also showing significant fluctuation trend (χ2 = 13.619, P < 0.001). Pearson correlation revealed shows that anxiety and depression during early, middle, and late pregnancy were positively correlated (P < 0.001). From pregnancy to six weeks postpartum, anxiety and depression during pregnancy (early, middle, and late) correlated negatively with depression at six weeks postpartum (P < 0.001). Cross-lag modeling indicated that anxiety and depressive symptoms during pregnancy exerted significant time-lagged predictive effects on postpartum depression (P < 0.001).
CONCLUSION
Anxiety and depression during pregnancy demonstrate dynamic evolution and both have time-lagged predictive effects on postpartum depression.
Core Tip: Hormonal fluctuations, anatomical changes, and evolving family roles during pregnancy often disrupt women’s physical and emotional balance, leading to mental health challenges. This study revealed that fluctuations in anxiety and depressive emotions at different gestational stages have time-lagged associations with postpartum depression, offering a new insight for clinical management of maternal emotional health during and after pregnancy.
