Objective To investigate the incidence of postnatal depressive symptoms among women with abnormal psychological screening results at first registration for antenatal check up, and to explore the influencing factors. Methods A total of 681 pregnant women who had abnormal psychological screening results at the first registration for antenatal check up were enrolled into the cohort. The women were re-assessed post-partum for depressive symptoms with the Edinburgh Postpartum Depression Scale （EPDS）.Multivariate logistic regression analysis was used to explore the influencing factors of postnatal depressive symptoms. Results Among the 681 participants,105 (15.4%) had postnatal depressive symptoms.A history of personal mental disorders, having an-xiety symptoms alone in the 3rd trimester, having depressive symptoms alone in the 3rd trimester and having both anxiety and depressive symptoms in the 3rd trimester, were risk factors of postnatal depressive symptoms （P＜0.05,P＜0.01）. Conclusion The incidence of postnatal depressive symptoms in women with abnormal psychological screening results at the first registration for antenatal check up is not high, which implies that appropriate time points and instruments for psychological screening during pregnancy may need reconsideration.It is necessary to pay attention to follow-up of pregnant women with abnormal psychological screening results in the 3rd trimester of pregnancy and those with a history of mental disorders.Meanwhile, it is necessary to further improve the ability of medical workers to practice mental care, in an effort to ensure the effectiveness of mental health care.