{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:24:24Z","timestamp":1786947864415,"version":"build-2736575974"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depressive symptoms in late pregnancy are common and may adversely affect maternal well-being and perinatal outcomes. Current antenatal screening mainly relies on symptom scales administered at a single time point, which may be insufficient for identifying women who are likely to develop depressive symptoms later in pregnancy. Dyadic coping reflects how partners communicate, support each other, and respond jointly to stress, but its value in risk prediction for third-trimester depressive symptoms remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study recruited pregnant women receiving routine antenatal care at a tertiary hospital in Shanghai, China. Recruitment lasted from January 2025 to August 2025. Baseline predictors were collected at 21\u201324\u202fweeks of gestation and included demographic characteristics, pregnancy-related clinical data, laboratory indicators, and dyadic coping. Third-trimester depressive symptoms were assessed at 28 to 36\u202f+\u202f6\u202fweeks of gestation using the 24-item Hamilton Depression Rating Scale. Multivariable logistic regression was used to develop a basic clinical-demographic model and a dyadic coping-enhanced model. Model performance was evaluated using discrimination, calibration, Brier score, decision curve analysis, and bootstrap internal validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 370 complete cases were included, of whom 86 developed third-trimester depressive symptoms. During baseline screening, 11 women were excluded solely for meeting the exclusion criterion of baseline HAMD-24 total score \u22658. Women with depressive symptoms had significantly lower dyadic coping scores than those without symptoms. In the basic model, younger age, higher mean platelet volume, gestational hypertension, intrauterine growth and amniotic fluid abnormalities, and immune and autoimmune diseases were associated with third-trimester depressive symptoms. After adding dyadic coping, the area under the curve increased from 0.739 to 0.826, and the Brier score decreased from 0.152 to 0.127. The enhanced model also showed significant improvement in integrated discrimination improvement and net reclassification improvement. After bootstrap correction, the area under the curve was 0.719 for the basic model and 0.810 for the dyadic coping-enhanced model. Decision curve analysis showed that the enhanced model provided greater net benefit across most clinically relevant threshold probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dyadic coping assessed in the second trimester provided incremental predictive value for third-trimester depressive symptoms beyond routinely available clinical information. Incorporating dyadic coping into antenatal risk assessment may provide preliminary risk screening reference for our single-center cohort to identify women requiring enhanced psychological and family support. However, multi-center external validation across diverse obstetric populations is required before this model can be routinely implemented in general clinical settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1892119","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:26:15Z","timestamp":1786944375000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Second-trimester dyadic coping and risk of third-trimester depressive symptoms: development and internal validation of a prediction model"],"prefix":"10.3389","volume":"13","author":[{"given":"Bingxin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengru","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Nursing, Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congcong","family":"Cao","sequence":"additional","affiliation":[{"name":"School of Nursing, Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Peng","sequence":"additional","affiliation":[{"name":"School of Nursing, Shanghai Jiao Tong University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing, Shanghai Jiao Tong University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Tongji Hospital Affiliated to Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai Tenth People\u2019s Hospital Affiliated to Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12888-015-0452-7","article-title":"Prevalence and predictors of antenatal depressive symptoms among Chinese women in their third trimester: a cross-sectional survey","volume":"15","author":"Zeng","year":"2015","journal-title":"BMC Psychiatry"},{"key":"ref2","first-page":"291","article-title":"Effect of domestic violence on pregnancy outcome","volume":"19","author":"Zareen","year":"2009","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1186\/s12888-023-05030-1","article-title":"Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression","volume":"23","author":"Yu","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1186\/s12884-024-06830-3","article-title":"Sleep quality disparities in different pregnancy trimesters in low- and middle-income countries: a systematic review and meta-analysis","volume":"24","author":"Mislu","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e092233","DOI":"10.1136\/bmjopen-2024-092233","article-title":"Depressed mood as a transdiagnostic target relevant to anxiety and\/or psychosis: a scoping review","volume":"15","author":"Mavindidze","year":"2025","journal-title":"BMJ Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e0261096","DOI":"10.1371\/journal.pone.0261096","article-title":"First and second trimester ultrasound in pregnancy: a systematic review and metasynthesis of the views and experiences of pregnant women, partners, and health workers","volume":"16","author":"Moncrieff","year":"2021","journal-title":"PLoS One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"325","DOI":"10.5498\/wjp.v11.i7.325","article-title":"Risk factors for antenatal depression: a review","volume":"11","author":"M\u00edguez","year":"2021","journal-title":"World J Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12888-021-03684-3","article-title":"Risk factors of perinatal depression in women: a systematic review and meta-analysis","volume":"22","author":"Yang","year":"2022","journal-title":"BMC Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e31","DOI":"10.1017\/SJP.2022.28","article-title":"Dyadic coping, dyadic coping based gratitude (DC-G), and relationship satisfaction in Pakistani couples","volume":"25","author":"Shujja","year":"2022","journal-title":"Span J Psychol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"16211","DOI":"10.3390\/ijerph192316211","article-title":"The role of attachment and dyadic coping in shaping relational intimacy: actor-partner interdependence model","volume":"19","author":"Wendolowska","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1002\/sim.7992","article-title":"Minimum sample size for developing a multivariable prediction model: PART II - binary and time-to-event outcomes","volume":"38","author":"Riley","year":"2019","journal-title":"Stat Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A RATING SCALE FOR DEPRESSION","volume":"23","author":"Hamilton","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jpsychires.2010.05.017","article-title":"Validity of depression rating scales during pregnancy and the postpartum period: impact of trimester and parity","volume":"45","author":"Ji","year":"2011","journal-title":"J Psychiatr Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1097\/AOG.0000000000003892","article-title":"American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia: ACOG practice bulletin summary, number 222","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1037\/pas0000329","article-title":"Validation of the dyadic coping inventory with Chinese couples: factorial structure, measurement invariance, and construct validity","volume":"28","author":"Xu","year":"2016","journal-title":"PsycholAssess"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"104190","DOI":"10.1016\/j.midw.2024.104190","article-title":"Perceived stress and prenatal depression symptoms among couples with gestational diabetes mellitus: the mediating role of dyadic coping","volume":"139","author":"Ding","year":"2024","journal-title":"Midwifery"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.2147\/IJWH.S458763","article-title":"Pregnant women\u2019s dyadic coping and associated factors: a cross-sectional study utilizing latent profile analysis","volume":"16","author":"Yan","year":"2024","journal-title":"Int J Women's Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.jad.2015.02.023","article-title":"Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis","volume":"178","author":"Pilkington","year":"2015","journal-title":"J Affect Disord"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1097\/PSY.0000000000000004","article-title":"APrON Study Team. The buffering effect of social support on hypothalamic-pituitary-adrenal axis function during pregnancy","volume":"75","author":"Giesbrecht","year":"2013","journal-title":"Psychosom Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1017\/S0033291720003062","article-title":"Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: a systematic review and meta-analysis","volume":"50","author":"Shay","year":"2020","journal-title":"Psychol Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e109","DOI":"10.1192\/j.eurpsy.2025.10058","article-title":"Trajectories of antenatal depression and adverse pregnancy outcomes: a prospective cohort study","volume":"68","author":"Chen","year":"2025","journal-title":"Eur Psychiatry"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/14767050701209560","article-title":"Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature","volume":"20","author":"Alder","year":"2007","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1326151","DOI":"10.3389\/fpsyt.2024.1326151","article-title":"Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model","volume":"15","author":"Albertini","year":"2024","journal-title":"Front Psych"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1144170","DOI":"10.3389\/fmed.2023.1144170","article-title":"Preeclampsia pathophysiology and adverse outcomes during pregnancy and postpartum","volume":"10","author":"Bisson","year":"2023","journal-title":"Front Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"950","DOI":"10.17762\/jaz.v44i4.2406","article-title":"Perceived stress, quality of life and pregnancy outcomes among women with hypertensive disorders of pregnancy (HDP) and role of midwives in it: a systematic review","volume":"44","author":"Nayak","year":"2023","journal-title":"J Adv Zool"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1614577","DOI":"10.3389\/fpsyt.2025.1614577","article-title":"Antidepressants and hypertensive disorders in pregnancy: a retrospective cohort analysis","volume":"16","author":"Breadon","year":"2025","journal-title":"Front Psych"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"561","DOI":"10.3390\/children10030561","article-title":"Amniotic fluid disorders: from prenatal management to neonatal outcomes","volume":"10","author":"Huri","year":"2023","journal-title":"Children (Basel)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.3390\/healthcare3041212","article-title":"Perinatal maternal mental health, fetal programming and child development","volume":"3","author":"Lewis","year":"2015","journal-title":"Healthcare (Basel)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"200535","DOI":"10.1016\/j.ijcrp.2025.200535","article-title":"Mean platelet volume and long-term cardiovascular outcomes in patients with type 2 diabetes mellitus","volume":"27","author":"Dahan","year":"2025","journal-title":"Int. J. Cardiol. Cardiovasc. Risk Prev."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.3390\/cells11081256","article-title":"Proteomics and metabolomics profiling of platelets and plasma mediators of thrombo-inflammation in gestational hypertension and preeclampsia","volume":"11","author":"De Almeida","year":"2022","journal-title":"Cells"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41392-024-01738-y","article-title":"Major depressive disorder: hypothesis, mechanism, prevention and treatment","volume":"9","author":"Cui","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"105222","DOI":"10.5498\/wjp.v15.i6.105222","article-title":"Perceived stress, risk factors and prognostic monitoring loci for the development of depression","volume":"15","author":"Li","year":"2025","journal-title":"World J Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"955672","DOI":"10.3389\/fphar.2022.955672","article-title":"Inflammatory pathophysiological mechanisms implicated in postpartum depression","volume":"13","author":"Zhu","year":"2022","journal-title":"Front Pharmacol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1892119\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:26:16Z","timestamp":1786944376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1892119\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":33,"alternative-id":["10.3389\/fmed.2026.1892119"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1892119","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"1892119"}}