To clarify the causal relationship between body image comparison on social media and perinatal depression in pregnant women.

A convenience sampling method was employed to select pregnant women attending prenatal check-ups at a tertiary hospital in Hefei, Anhui Province, from September 2023 to April 2024. A longitudinal survey was conducted during late pregnancy (T1) and six weeks postpartum (T2) using a general information questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and a body image comparison scale for social media. Data analysis was performed using SPSS 23.0 and Mplus 8.3 statistical software. Pearson correlation analysis was conducted to examine the relationship between body image comparison on social media and depression scores at T1 and T2, while a cross-lagged model was constructed using Mplus 8.3 to explore the causal relationship between body image comparison and perinatal depression.

A total of 277 pregnant women were included in the study, with depression rates of 34.30% and 21.66% at T1 and T2, respectively. A positive correlation was found between body image comparison on social media and depression scores at both T1 and T2 (P < 0.010). Body image comparison at T1 positively predicted depression at T2 (β=0.237, P=0.001).

Pre-pregnancy body image comparison on social media can predict postpartum depression.