Which of the following risk factors should a nurse include when planning a class on postpartum depression for a group of clients who are pregnant?

Choice A reason: Postterm birth, beyond 42 weeks, increases risks like fetal distress or meconium aspiration but is not a direct risk factor for postpartum depression. Psychological stressors, not gestational duration, primarily drive depression. Hormonal changes and stress are key contributors, and postterm birth lacks a direct neurochemical or psychosocial link to depression. Choice B reason: Middle-class family income is not a specific risk factor for postpartum depression. Socioeconomic status may influence access to care, but depression is more closely tied to hormonal, psychological, and social stressors. Income alone does not directly alter neuroendocrine pathways or psychosocial dynamics that contribute to postpartum depression risk in pregnant clients. Choice C reason: Unplanned pregnancy is a significant risk factor for postpartum depression, as it increases psychological stress and anxiety. Stress hormones like cortisol can exacerbate mood dysregulation, and lack of preparedness may strain coping mechanisms. This psychosocial stressor disrupts emotional stability, increasing the likelihood of depressive symptoms in the postpartum period. Choice D reason: Working full-time outside the home is not a direct risk factor for postpartum depression. While work-life balance may contribute to stress, it lacks a specific neurochemical or psychosocial link to depression compared to factors like unplanned pregnancy. Hormonal and emotional stressors are stronger predictors of postpartum mood disorders.