Objectives. To estimate postpartum depression at two months (PPD) prevalence and its related risk factors. Design. Multicentre prospective cohort study. Setting. France. Population or sample. Representative sample of 7,133 women participating to the French National Perinatal Survey (ENP) over one week in March 2021. Methods. Data on maternal characteristics, course of pregnancy/delivery, and child’s health were collected from face-to-face interviews in maternity wards and/or medical records, and a self-questionnaire (including the Edinburgh Postnatal Depression Scale (EPDS)) at two months postpartum. Women with an EPDS score >=13 were considered to have PPD. Poisson regression models with robust variance were used to estimate adjusted prevalence ratios (aPR) for PPD. Main Outcome Measures. PPD Results. PPD prevalence at two months was 16.7% (95%CI[15.7-17.7]). Factors significantly associated with PPD were: i/ age<=29 or >=40 years (maximum aPR=1.41 95%CI[1.12-1.77] obtained for 15-24 year-olds vs 35-39 year-olds), ii/ being born in North Africa (1.29[1.02-1.64] vs France), iii/ having a lower level of health literacy (1.23[1.14-1.35]), iv/ having a history of psychological (1.45[1.24-1.69]) or psychiatric (1.52[1.23-1.88]) care since adolescence (vs none), v/ receiving little/no support or good support during pregnancy (1.80[1.52-2.14] and 1.31[1.15-1.48] vs. receiving very good support), vi/ reporting feelings of sadness (1.92[1.65-2.25]), anhedonia (1.69[1.36-2.11]) or both (2.61[2.26-3.01]) during pregnancy (vs none of these feelings), vii/ having had an instrumental vaginal delivery (1.18[1.01-1.38] vs spontaneous vaginal delivery). Conclusions. Our findings on PPD (prevalence and risk factors) could guide policies on early identification and preventive support for women in the perinatal period.

Objective: A recent systematic review found that education programs in perinatal mental health (PMH) had limited effects on detection, referral, and support of parents with perinatal mental health problems (PMHPs). This qualitative study sought to explore the experiences, views and priorities of persons with lived experience (PWLEs), obstetric providers (OPs), childcare health providers (CHPs) and mental health providers (MHPs) on education in PMH. Design/Setting: We used a participatory research design, i.e. co-production by academic researchers and researchers with lived experience as equal partners. We recruited PWLEs through Maman Blues’ association and a centre for psychiatric rehabilitation, and providers through perinatal health networks. Sample/Methods: We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PWLEs; 30 OPs; 11 CHPs and 19 MHPs). We used Braun & Clarke’s inductive six-step process in the thematic analysis. Results: We found some degree of difference in the priorities for education in PMH identified by PWLEs (e.g. person-centred collaborative perinatal healthcare) and providers (e.g. knowledge about PMHPs). Providers considered PMH assessment as part of their role but reported feeling ill-prepared to do so and negative attitudes about their role in perinatal mental health care for parents with suicidal ideations or serious mental illness. Organisational factors comprised PMH integration into standard perinatal healthcare and common culture between non-MHPs and MHPs. Conclusions: Education programs in PMH should be co-designed with PWLEs and focus on providing collaborative person-centred care for all parents.

Objective To identify risk factors of early and late postpartum depression (PPD) among a wide range of variables including sociodemographic characteristics, childhood trauma, stressful life events during pregnancy, and history of personal and family psychiatric disorders; and to assess the contribution of each risk factor. Design Nested case-control in a prospective longitudinal cohort study. Setting Eight maternity departments in Paris metropolitan area, France. Sample 3310 women with deliveries between November 2011 and June 2016 Methods Cases were identified as women with early or late PPD. Controls were all cohort participants without either early or late PPD. Main Outcome Measures Early and late PPD are assessed respectively at 2 months and one year postpartum. Results: Stressful life events during pregnancy have a dose response relationship with both early and late PPD: each additional event increased the risk of PPD. In multivariable models, early PPD was independently associated with emotional neglect during childhood (aOR:1.6, 95%CI:1.0-2.6), stressful life event during pregnancy (aOR:1.8, 95%CI:1.4-2.4), physical concomitant chronic disease during pregnancy (aOR:1.5, 95%CI:1.0-2.1), and a history of depression (aOR:1.8, 95%CI:1.4-2.4); whereas late PPD was significantly associated with unemployment (aOR:1.8, 95%CI:1.1-2.8), emotional abuse during childhood (aOR:2.2, 95%CI:1.3-3.9), stressful life event during pregnancy (aOR:2.2, 95%CI:1.6-2.9), emergency consultation during pregnancy (aOR:1.4, 95%CI:1.0-1.8), serious postpartum complications (aOR:1.7; 95%CI:1.0-2.8) and personal and family history of mood disorder (aOR:1.5, 95%CI:1.1-2.0, and aOR:1.4, 95%CI:1.0-1.8). Conclusion: Early and late PPD presented distinct patterns of correlates, with sociodemographic, psychiatric and trauma factors. These results have important consequences in terms of prevention and specific care