Which of the following are risk factors for postpartum depression? (Select all that apply.)

Choice A rationale Strong social support is considered a protective factor against postpartum depression (PPD), not a risk factor. The presence of a supportive network, including partners, family, and friends, can mitigate the stress and isolation associated with new parenthood, thereby decreasing the likelihood of developing significant mood disorders such as PPD. Choice B rationale Age is not a consistent or strong independent risk factor for postpartum depression; however, young maternal age (e.g., under 20) is sometimes associated with higher risk, possibly due to increased socioeconomic stressors or lack of maturity/support. Age over 30 is generally not considered a primary risk factor for PPD. Choice C rationale Low levels of stress are also a protective factor. High levels of chronic or acute stress, particularly related to financial difficulties, relationship conflict, or complicated birth experiences, significantly increase the physiological and psychological burden on the mother, thus increasing the vulnerability to PPD. Choice D rationale Stressful life events, such as moving, job loss, or relationship difficulties occurring during pregnancy or the postpartum period, significantly elevate the risk for postpartum depression. These events increase psychological stress and deplete coping resources, leading to greater vulnerability to developing major depressive disorder during the hormonally labile postpartum period. Choice E rationale A history of postpartum blues (a transient, mild mood disturbance) or previous episodes of depression, whether related to pregnancy or not, are significant risk factors for developing the more severe and persistent postpartum depression. This suggests a pre-existing physiological or psychological vulnerability to mood dysregulation in the face of hormonal and sleep changes. Choice F rationale A family history of depression (including PPD in a first-degree relative) is a significant independent risk factor, suggesting a possible genetic or inherited predisposition to mood disorders. The presence of a genetic vulnerability combined with the hormonal fluctuations of the postpartum period can trigger the onset of PPD.