Antenatal Depression Risk and Mental Health Literacy: A Correlational Study Among Second- and Third-Trimester Pregnancies

Background/Objectives: Antenatal depressive symptoms are common but frequently under-recognized. Although mental health literacy may support symptom recognition and help-seeking, its relationship with antenatal depressive symptoms remains unclear. This study examined the association between overall mental health literacy and antenatal depressive symptoms among women in the second and third trimesters of pregnancy. Methods: This cross-sectional correlational study included 568 pregnant women consecutively recruited from a university hospital’s obstetrics and gynecology outpatient clinics. The Edinburgh Postnatal Depression Scale (EPDS) and Mental Health Literacy Scale (MHLS) were administered. Spearman correlation and multivariable linear and logistic regression were used; multiple imputation handled missing covariates. Results: The mean EPDS score was 8.92 ± 5.68, and 41.9% (n = 238) screened positive for elevated depressive symptoms at the EPDS ≥ 10 threshold. A one-standard-deviation increase in the MHLS total score was associated with neither EPDS total scores (B = 0.011, 95% CI: −0.451 to 0.473, p = 0.963) nor EPDS ≥ 10 screening positivity (aOR = 1.093, 95% CI: 0.911 to 1.312, p = 0.337). Unplanned pregnancy (aOR = 1.975, p = 0.001) and third-trimester status (aOR = 1.774, p = 0.014) were associated with higher odds of screening positivity. In exploratory joint analyses, knowledge-oriented literacy was positively and resource-oriented literacy negatively associated with EPDS scores; both remained significant after Holm correction. The resource-oriented association was no longer significant when examined separately. Conclusions: Overall mental health literacy was not associated with antenatal depressive symptom severity or screening positivity. Opposing, model-dependent subscale findings require replication. These findings support assessing depressive symptoms independently of mental health literacy scores and considering pregnancy planning and gestational stage during antenatal psychosocial assessment.