The relationship between fear of childbirth and prenatal depression in pregnant women during pregnancy: a cross-lagged analysis.

Objective: To analyze the reciprocal predictive relationship or quasi-causal relationship between fear of childbirth and antenatal depression in pregnant women via cross-lagged modeling.

Methods: Pregnant women who attended prenatal examinations at a Grade 3 A hospital in Bengbu City, Anhui Province, from November 2022 to March 2023 were randomly selected as the study subjects. A total of 219 pregnant women were followed up longitudinally three times during pregnancy using the General Information Questionnaire, the Wijma Expectation/Experience of Childbirth Questionnaire, and the Edinburgh Postnatal Depression Inventory, and were then statistically analyzed using a cross-lagged model.

Results: The results revealed a positive correlation between maternal fear of childbirth and prenatal depression score on all three measures (r = 0.426, 0.519, 0.420, P < 0.001). Repeated measures ANOVA showed that maternal fear of childbirth tended to gradually increase during pregnancy, while prenatal depression first decreased and then stabilized. The results of the cross-lagged model showed that the T1 and T2 fear of childbirth scores significantly predicted the T2 and T3 prenatal depression scores (β = 0.184, 0.112, P < 0.05). The T1 fear of childbirth score significantly predicted the T2 fear of childbirth score (β = 0.127, P < 0.05), but the T2 fear of childbirth score was not significantly predictive of the T3 fear of childbirth score (β = 0.060, P > 0.05).

Conclusion: Fear of childbirth and antenatal depression interact with each other during pregnancy, and this relationship develops dynamically, with fear of childbirth having a more stable and lasting predictive effect on antenatal depression. Maternal mental health status can be assessed early in pregnancy via our pregnancy health care services to guide targeted interventions throughout the perinatal period.