Strengths and Limitations
The principal strengths of the present study are the prospective,
multicenter design and the size of the sample. To the best of our
knowledge, this is the largest sample to date to examine the
determinants of PPD prospectively, with a good overall response rate at
1 year. In addition, all psychiatric diagnoses are based on a rigorous
clinical assessment using DSM-5- criteria. Moreover, the evaluations at
8 weeks and then at 1 year postpartum make it possible to distinguish 2
types of PPD, with different determinants for early and late PPD.
Finally, IGEDEPP provides an extensive assessment of a wide range of
determinants, including socio-demographic characteristics, personal and
family history of psychiatric disorders, childhood trauma, as well as
stressful life events during pregnancy and postpartum, whether related
to pregnancy or not.
A main limitation of the study is the fact that all included women were
Caucasian, due to the original objective of the cohort: studying genetic
determinants of PPD. The women included also had a high level of
education and favorable socio-economic conditions. However, the
prevalence of postpartum depression as well as prevalence of the
psychiatric disorders assessed were consistent with other samples of
women, as discussed elsewhere (29).