BACKGROUND Personal and family history of psychiatric disorders are key risk factors for postpartum depression (PPD), yet their combined contribution has been understudied. OBJECTIVE To examine personal and family psychiatric history, alone and combined, and their effect on absolute risk and relative risk (RR) of mild/moderate or severe PPD. METHODS In this cohort study, we used data from 142 064 childbirths with PPD screenings from 2015 to 2021 merged with population registers. Exposures were personal and family psychiatric history defined as a psychiatric hospital contact or psychotropic prescription fills by index mothers and their parents prior to delivery. Outcomes were mild/moderate PPD (Edinburgh Postnatal Depression Scale, cut-off: ≥11 within 12 weeks post partum) and severe PPD (antidepressant fill or depression diagnosis within 6 months post partum). We calculated absolute risks and RRs using Poisson regression models adjusted for parity, education, maternal age, and calendar year. FINDINGS Of the 142 064 participants, 23.4% had no psychiatric history, 47.4% had only family history, 6.0% had only personal history, and 23.2% had both. The latter group had the highest risk of PPD: absolute risk of mild/moderate PPD was 11.7% (95% CI 11.5%; 11.8%), and adjusted RR: 2.35 (95% CI 2.22; 2.49). Alone, personal psychiatric history was the most potent risk factor. Dose-response relationship based on severity of personal and family psychiatric history was found. DISCUSSION Our study documents a substantial association between personal and family psychiatric history and PPD risk. CLINICAL IMPLICATIONS Evaluating combinations of risk factors is important to improve risk assessment.

中文翻译：

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识别产后抑郁症：利用关键风险因素进行早期检测。


背景精神疾病的个人史和家族史是产后抑郁症（PPD）的关键危险因素，但其综合影响尚未得到充分研究。目的 调查个人和家族精神病史（单独和综合）及其对轻度/中度或重度 PPD 绝对风险和相对风险 (RR) 的影响。方法 在这项队列研究中，我们使用了 2015 年至 2021 年 142 064 例进行 PPD 筛查的分娩数据，并与人口登记册合并。暴露是个人和家庭精神病史，定义为指标母亲及其父母在分娩前与精神病医院的接触或填写的精神药物处方。结果为轻度/中度 PPD（爱丁堡产后抑郁量表，截止值：产后 12 周内≥11）和重度 PPD（产后 6 个月内服用抗抑郁药物或诊断为抑郁症）。我们使用针对胎次、教育程度、产妇年龄和日历年份进行调整的泊松回归模型计算了绝对风险和 RR。结果 在 142064 名参与者中，23.4% 的人没有精神病史，47.4% 的人只有家族史，6.0% 的人只有个人史，23.2% 的人两者都有。后者的 PPD 风险最高：轻度/中度 PPD 的绝对风险为 11.7%（95% CI 11.5%；11.8%），调整后的 RR：2.35（95% CI 2.22；2.49）。单独来看，个人精神病史是最有力的危险因素。发现了基于个人和家族精神病史严重程度的剂量反应关系。讨论 我们的研究记录了个人和家族精神病史与 PPD 风险之间存在显着关联。临床意义 评估风险因素的组合对于改进风险评估非常重要。