Trajectories of Depressive Symptoms and Fatigue Among Postpartum Women

Objectives: To identify and characterize the trajectories of depressive and fatigue symptoms and determine the relationship between these two trajectories and associated predictors. Design: A prospective, follow-up study. Setting: A teaching medical center in central Taiwan. Participants: A convenience sample of 121 low-risk, childbearing women. Methods: Depressive and fatigue symptoms were assessed using the Edinburgh Postnatal Depression Scale and Fatigue Continuum Form respectively during the third trimester (time 1), one day postpartum (time 2), three days postpartum (time 3), and one week postpartum (time 4). Participants also completed structured questionnaires on demographic features, health status, and sleep quality. Results: The mean age of participants was 31.2 years. We observed four distinctive trajectories of depressive symptoms and three trajectories of fatigue using group-based trajectory modeling. A frequent cooccurrence of similar levels of these symptoms was found; that is, mothers in the high-risk depressive symptoms group were most likely to fall into the high-risk group for fatigue. Joint trajectories were predicted by poor sleep score (odds ratio = 2.96, 95% confidence interval = 1.2, 7.3) using multinomial logistic regression analysis. Conclusion: Overlapping but distinct trajectories of depressive symptoms and fatigue were found. These results suggest that differentiation between depressive symptoms and fatigue is possible and important for improving care during the early postpartum period.