Early and late postpartum depression exhibit distinct correlates: the
IGEDEPP prospective cohort study
Abstract
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