Background <p>Depression and lumbopelvic dysfunction, including low back pain and pelvic floor disorders, are both common conditions that affect women during pregnancy; however, there is a gap in understanding the association between the two. Thus, the aim of this study was to identify lumbopelvic risk factors for depression in pregnant women.</p> Methods <p>In this cross-sectional study, lumbopelvic dysfunction (low back pain, urinary incontinence, fecal incontinence, constipation, and/or sexual dysfunction) was examined in 375 pregnant Nicaraguan women. The women were categorized into two groups, pregnant women with and without symptoms of depression, based on a cut-off of ≥ 13 on the Edinburg Depression Scale, to define higher symptoms of depression, and ANOVA models were applied to assess the role of sociodemographic data and lumbopelvic dysfunction on depression risk. Additionally, logistic regression analyses were conducted to identify lumbopelvic factors independently associated with a positive status of depression.</p> Results <p>Pregnant women with depression symptoms presented significantly worse lumbopelvic function than did their peers without symptoms of depression. Depression status was more strongly associated with low back pain (OR 2.17; IC 1.22, 3.86), constipation (OR 2.83; IC 1.52, 5.26) and sexual dysfunction (OR 1.99; IC 1.17, 3.40) but not in those with urinary incontinence (OR 1.50; IC 0.85, 2.65) or fecal incontinence (OR 1.70; IC 0.74, 3.91).</p> Conclusion <p>The association between depression during pregnancy and lumbopelvic dysfunction was significant, mainly in the presence of low back pain, constipation, and sexual dysfunction. These findings may be clinically useful for depression risk screening and for guiding future interventions in pregnant women, although their impact should be confirmed by longitudinal studies to understand the long-term consequences for both mothers and babies.</p>