Loneliness in mid- to late pregnancy and risk of depressive and anxiety symptoms in late pregnancy: a longitudinal cohort study
10.3760/cma.j.cn113903-20241023-00701
- VernacularTitle:孕中晚期孤独感与孕晚期抑郁焦虑症状的纵向关系
- Author:
Ziwei DING
1
;
Lanfang ZHAO
;
Le WANG
;
Shuangqin YAN
;
Lanci XIE
;
Guopeng GAO
;
Tianli ZHU
;
Jingjing LIU
;
Tuyan FAN
;
Fengyu YANG
;
Hui GAO
;
Huayan MO
;
Wenjing QIANG
;
Beibei ZHU
;
Fangbiao TAO
Author Information
1. 安徽医科大学公共卫生学院，合肥大健康研究院健康大数据与群体医学研究所，合肥 230032
- Publication Type:Journal Article
- Keywords:
Loneliness;
Anxiety;
Depression;
Pregnant women;
Longitudinal studies
- From:
Chinese Journal of Perinatal Medicine
2025;28(12):1107-1114
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the prevalence, risk factors, and longitudinal associations of loneliness during mid- to late pregnancy with anxiety and depressive symptoms in late pregnancy.Methods:In this prospective cohort study, 1 107 pregnant women at 24-28 weeks' gestation were enrolled between June 2021 and December 2022. Psychological status was assessed during mid-pregnancy (24-28 weeks) and late pregnancy (≥32 weeks) using standardized electronic questionnaires, including the Revised University of California Los Angeles Loneliness Scale (UCLA) Loneliness Scale-Short Form (Cronbach's α=0.82), Patient Health Questionnaire-9 ( α=0.86), and Generalized Anxiety Disorder-7 ( α=0.88). Multivariate logistic regression identified independent risk factors for loneliness. Cross-lagged path models analyzed the longitudinal predictions between loneliness and anxiety/depressive symptoms. Results:The prevalence of loneliness decreased significantly from 10.8% (120/1 107) in mid-pregnancy to 4.8% (37/777) in late pregnancy ( χ2=21.81, P<0.001). Multivariate analysis identified independent risk factors for loneliness: age <30 years ( OR=1.70, 95% CI: 1.15-2.50), annual household income <50 000 CNY ( OR=2.53, 95% CI: 1.28-5.02), unemployment during pregnancy ( OR=1.57, 95% CI: 1.03-2.39), history of alcohol consumption ( OR=1.63, 95% CI: 1.03-2.56), and the presence of mid-pregnancy depressive ( OR=2.76, 95% CI: 1.51-5.04) and anxiety symptoms ( OR=1.65, 95% CI: 1.01-2.71) (all P<0.05). Cross-lagged path models indicated bidirectional associations between loneliness and both anxiety ( β=0.32, P<0.01) and depressive symptoms ( β=0.28, P<0.01). However, the predictive effect of loneliness on subsequent depressive and anxiety symptoms ( β=0.28-0.32) was substantially stronger than the reverse prediction (mid-pregnancy anxiety on late-pregnancy loneliness: β=0.12; mid-pregnancy depression on late-pregnancy loneliness: β=0.11). Loneliness demonstrated high temporal stability (autoregressive effects β=0.29-0.32). Conclusion:Loneliness in mid-pregnancy exhibits a symmetric bidirectional association with anxiety and depressive symptoms in late pregnancy, suggesting it may be a core driver in the development of these emotional symptoms. Younger maternal age (<30 years), low household income (<50 000 CNY/year), unemployment during pregnancy, and a history of alcohol consumption were associated with a higher risk of loneliness and should be prioritized for psychological screening and intervention.
