Obstetrical events at the initial evaluation
Obstetrical characteristics were assessed by a questionnaire at the maternity department, covering factors known to be associated with PPD in the literature (see details in (Tebeka et al. (29)). Obstetric data collected during the first evaluation regarded: infertility, use of assisted reproductive technology (ART), the existence of a concomitant chronic physical disease, previous pregnancies, multiple pregnancy, one or more emergency consultation or hospitalization during pregnancy, or a complication of pregnancy such as threatened preterm labor, gestational hypertension or gestational diabetes. Data on delivery included: type of delivery (vaginal or cesarean, before or during labor), use of obstetric analgesia and presence of perineal trauma (≥ 2-degree perineal tear). Information on prematurity (< 37 weeks of gestation), low birth weight (<2500g), maternal or neonatal transfer to intensive care, postpartum hemorrhage and breastfeeding were also collected.
Obstetrical events with a negative impact considered as ”marked” or ”severe” by the woman were considered as stressful.