Journal Article

Moderating effect of dysmenorrhea on the association between number of pregnancies and antenatal depression in the third trimester: a cross-sectional study

Zhao, Lulu, Liu, Yanlong, Liu, Guohui, Yang, Fan, Guo, Zixuan, Ma, Duo, Wang, Fan, Chen, Guangxue, Kong, Tiantian, Wang, Xiaoxue

2026

Overview

Objective To investigate the relationship between third-trimester antenatal depression (AND) and the number of pregnancies, considering the possible moderating role of dysmenorrhea. Methods A total of 1,178 pregnant women in their third trimester were included in this cross-sectional observational study. The pregnant women were categorized into those with and without dysmenorrhea. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), a validated instrument for perinatal depression screening applicable to both antenatal and postnatal populations. Regression analysis and simple slope analysis to evaluate the moderating effect of dysmenorrhea. Results The non-dysmenorrhea group exhibited significantly higher age, pre-pregnancy BMI, number of pregnancies or deliveries, and lower EPDS scores than the dysmenorrhea group ( p  < 0.05). In both groups, an inverse relationship was observed between educational levels and EPDS scores ( p  < 0.001). For the non-dysmenorrhea group, age was inversely related to the EPDS scores ( p  < 0.001). Within the dysmenorrhea group, the number of Pregnancies and the count of deliveries demonstrated a positive association with EPDS scores ( p  < 0.001). A negative correlation with EPDS scores was found for both age and the educational levels of the husbands ( p  < 0.05). Dysmenorrhea was linked to a positive correlation with EPDS scores ( p  < 0.001). Furthermore, the interaction between the number of pregnancies and the presence of dysmenorrhea also demonstrated a positive correlation with EPDS scores ( p  < 0.05). Conclusion In conclusion, there is a significant positive link between the number of pregnancies and AND, with further exacerbation by dysmenorrhea. Highlights Dysmenorrhea worsens antenatal depression (AND) in pregnancy. Higher pregnancies/deliveries link to increased AND in dysmenorrhea. Age lowers AND in non-dysmenorrhea group. Dysmenorrhea and pregnancies interact to raise AND risk.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Adult / Age / Antenatal depression / Body mass index / Cross-Sectional Studies / Data collection / Depression - epidemiology / Depression - psychology / Dysmenorrhea / Dysmenorrhea - epidemiology / Dysmenorrhea - psychology / Education / Educational Status / Female / Gravidity / Gynecology / Hospitals / Humans / Marital status / Maternal and Child Health / Medicine / Medicine & Public Health / Menstruation / Mental depression / Moderation analysis / number of pregnancies / Pain / Parity / Pregnancy / Pregnancy Complications - epidemiology / Pregnancy Complications - psychology / Pregnancy Trimester, Third - psychology / Prenatal care / Psychiatric Status Rating Scales / Questionnaires / Regression analysis / Reproductive Medicine / Third trimester of pregnancy / Variables / Womens health / Young Adult