Perinatal depression (PND) can have either an antepartum or postpartum onset. Although the greatest risk factor for PND is previous depression history,de novoPND occurs with the majority of cases occurring in the postpartum. Timing of depression can impact etiology, prognosis, and response to treatment. Thus, it is crucial to study the impact of the heterogeneity of PND for better health outcomes. In this review, we outline the differences between antepartum and postpartum depression onset. We discuss maternal physiological changes that differ between pregnancy and postpartum and how these may differentially impact depression susceptibility. We highlight changes in the maternal steroid and peptide hormone levels, immune signalling, serotonergic tone, metabolic factors, brain morphology, and the gut microbiome. Finally, we argue that studying the heterogeneity of PND in clinical and preclinical models can lead to improved knowledge of disease etiopathology and treatment outcomes.

中文翻译：

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围产期抑郁症：疾病和动物模型的异质性

围产期抑郁症 (PND) 可以在产前或产后发病。虽然 PND 的最大危险因素是既往抑郁史，但大多数病例发生在产后，新发 PND。抑郁的发生时间会影响病因、预后和对治疗的反应。因此，研究 PND 异质性对改善健康结果的影响至关重要。在这篇综述中，我们概述了产前和产后抑郁发作之间的差异。我们讨论了孕期和产后不同的母体生理变化，以及这些变化如何对抑郁易感性产生不同的影响。我们强调了母体类固醇和肽激素水平、免疫信号、血清素能基调、代谢因素、大脑形态和肠道微生物组的变化。最后，