INSERM U1266, Université de Paris, Paris, France.
Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France.
BJOG. 2021 Sep;128(10):1683-1693. doi: 10.1111/1471-0528.16688. Epub 2021 Apr 6.
To identify risk factors for early- and late-onset 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.
Nested case-control study in a prospective longitudinal cohort study.
Eight maternity departments in the Paris metropolitan area, France.
A cohort of 3310 women with deliveries between November 2011 and June 2016.
Cases were women with early- or late-onset PPD. Controls were women without depression during pregnancy or the postpartum period. Logistic regression adjusted on sociodemographic variables was performed for each outcome and a multivariable model was proposed based on a stepwise selection procedure.
Early- and late-onset PPD assessed at 2 months and 1 year postpartum, respectively.
Stressful life events during pregnancy have a dose-response relationship with both early- and late-onset PPD.
Early- and late-onset PPD presented distinct patterns of determinants. These results have important consequences in terms of prevention and specific care.
Early- and late-onset postpartum depression are associated with stressful life events and psychiatric history.
在广泛的变量范围内，包括社会人口统计学特征、儿童期创伤、怀孕期间的生活应激事件以及个人和家族精神病史，确定早发和晚发产后抑郁症（PPD）的风险因素，并评估每个风险因素的贡献。
前瞻性纵向队列研究中的巢式病例对照研究。
法国巴黎大都市区的 8 家产科病房。
2011 年 11 月至 2016 年 6 月分娩的 3310 名妇女队列。
病例为早发或晚发 PPD 的妇女。对照组为怀孕期间或产后无抑郁的妇女。对每个结局进行调整社会人口统计学变量的逻辑回归，并基于逐步选择程序提出多变量模型。
分别在产后 2 个月和 1 年评估早发和晚发 PPD。
怀孕期间的生活应激事件与早发和晚发 PPD 均呈剂量反应关系。
早发和晚发 PPD 呈现出不同的决定因素模式。这些结果在预防和特定护理方面具有重要意义。
早发和晚发产后抑郁症与生活应激事件和精神病史有关。
