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Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125021002221_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Including 185 observational studies (<jats:italic>n<\/jats:italic> = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81\u20132.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70\u20132.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35\u20131.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17\u20131.43), gestational diabetes (OR = 1.60, 95%CI 1.25\u20132.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57\u20130.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43\u20133.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17\u20131.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72\u20137.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18\u20132.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as \u2018convincing evidence\u2019. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and \u2018very low\u2019 for remaining factors.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125021002221_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. 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