Conclusions
This large, prospective, multicenter study highlights risk factors for
PPD: a personal vulnerability, in addition to psychiatric history, and
environmental factors, as well as childhood trauma and stressful life
events during pregnancy. Moreover, we have distinguished different
patterns of correlates for early depression and late PPD. Early PPD was
particularly associated with a physical chronic disease, while late
depression was associated with unemployment, as well as obstetric
factors like emergency consultation. Thus, the screening of both mental
and physical health during pregnancy is essential in order to offer
targeted prevention interventions.
Our results had direct and important clinical implications. Indeed,
prevention through earlier identification of at-risk women is the most
important strategy in decreasing PPD incidence (52,53). Clinicians
should keep in mind that one emergency consultation during pregnancy
could lead to an increased risk of PPD.
Whether personal biological vulnerability and stressful life events act
independently or interact with one another should be the focus of
further studies. With regard to the IGEDEPP cohort, genetic data will be
available and will be particularly relevant to the discussion of the
genetic aspects of PPD and potentially propose a gene-environment
interaction etiology.