{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T14:05:17Z","timestamp":1771596317612,"version":"3.50.1"},"posted":{"date-parts":[[2026,2,18]]},"group-title":"Epidemiology","reference-count":47,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,2,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>Perinatal depression (PD) is common and disabling, yet its longitudinal comorbidity patterns and predictability remain poorly understood. This study leveraged 8,804 women with delivery records in the All of Us cohort, including 438 with clinically diagnosed postpartum depression (PPD), to characterize multimorbidity trajectories and develop integrated prediction models. Comorbidities were grouped into 38 conditions across psychiatric, autoimmune, metabolic, neurological\/pain, and reproductive\/gynecological categories and examined both cross-sectionally and in monthly time bins from 250 months before to 500 months after delivery. Latent class analysis identified three pre- and post-delivery multimorbidity profiles and transitions between classes, while polygenic risk scores for depression and obstetric, clinical and socioeconomic variables were combined in machine learning models to predict PPD, post-delivery class membership, and symptom worsening among initially low-burden women. PPD cases showed higher odds of several psychiatric, autoimmune, and metabolic conditions and a tendency toward greater post-delivery comorbidity accumulation, particularly among women who were healthy pre-pregnancy. Multimorbidity profiles based on latent classes captured clinically meaningful risk gradients, and transition analyses revealed that incident PPD in previously healthy women marked a shift toward more symptomatic post-delivery profiles. Machine learning models achieved moderate discrimination for PPD and comorbidity outcomes and highlighted the importance of genetic liability, obstetric complications, and socioeconomic disadvantage, but low positive predictive values limit clinical implementation. These findings position PPD as a critical event in women\u2019s psychiatric, cardiometabolic, and pain-related health trajectories and support life-course, multimorbidity-informed screening and prevention strategies that extend beyond the traditional postpartum period.<\/jats:p>","DOI":"10.64898\/2026.02.18.26346535","type":"posted-content","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:30:23Z","timestamp":1771461023000},"source":"Crossref","is-referenced-by-count":0,"title":["Life-course comorbidity patterns and integrated prediction of postpartum depression, multimorbidity, and symptom progression"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9457-3277","authenticated-orcid":false,"given":"Selena","family":"Aranda","sequence":"first","affiliation":[{"name":"Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5313-024X","authenticated-orcid":false,"given":"Ariadna","family":"Bada-Navarro","sequence":"additional","affiliation":[{"name":"Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5318-4382","authenticated-orcid":false,"given":"Bru","family":"Cormand","sequence":"additional","affiliation":[{"name":"Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, Barcelona, Spain"},{"name":"Spanish Rare Diseases Research Network (CIBERER), Madrid, Spain"},{"name":"Institute of Research Sant Joan de D\u00e9u (IRSJD), Esplugues de Llobregat, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0675-9483","authenticated-orcid":false,"given":"Marta","family":"Cano","sequence":"additional","affiliation":[{"name":"Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain"},{"name":"Network Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-0888","authenticated-orcid":false,"given":"Narc\u00eds","family":"Cardoner","sequence":"additional","affiliation":[{"name":"Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain"},{"name":"Network Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain"},{"name":"Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"},{"name":"Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4048-6407","authenticated-orcid":false,"given":"Elisa","family":"Llurba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"},{"name":"Women and Perinatal Health Research Group, Institut de Recerca (IR) Sant Pau, Barcelona, Spain"},{"name":"Faculty of Medicine, Universitat Aut\u00f2noma de Barcelona, 08193 Barcelona, Spain"},{"name":"Spanish Network in Maternal, Neonatal, Child and Developmental Health Research (RICORS-SAMID, RD24\/0013\/0001), Instituto de Salud Carlos III, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5543-7320","authenticated-orcid":false,"given":"Marina","family":"Mitjans","sequence":"additional","affiliation":[{"name":"Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, Barcelona, Spain"},{"name":"Institute of Research Sant Joan de D\u00e9u (IRSJD), Esplugues de Llobregat, Spain"},{"name":"Network Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-0466","authenticated-orcid":false,"given":"Dora","family":"Koller","sequence":"additional","affiliation":[{"name":"Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, Barcelona, Spain"},{"name":"Women and Perinatal Health Research Group, Institut de Recerca (IR) Sant Pau, Barcelona, Spain"},{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026022005050646000_2026.02.18.26346535v1.1","doi-asserted-by":"crossref","unstructured":"Wang, Z. et al. 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