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.