Forms of varying severity of COVID-19 have been described in pregnant women, but in addition to the direct effects of the virus on the woman or the newborn, the pandemic context itself, as has been shown in contexts other than that of COVID-19, is likely to act as a psychological risk factor. Very recently, work published by Chinese, Italian and Canadian teams has indeed shown an increase in anxiety and depressive disorders in women during pregnancy. To date and to our knowledge, there is no data that allow us to know the impact that this context may have had on the mental health of pregnant women in France and there are no studies on the impact of this pandemic context on the prevalence of psychological disorders in the postpartum period, even though this period corresponds to a time of particular psychological vulnerability when the risk of maternal suicide is at its highest. The PsyCOVIDUM project is a repeated cross-sectional epidemiological study whose main objective is to estimate the evolution of the prevalence of women in the immediate postpartum period presenting depressive symptoms at 4 defined times in relation to the COVID-19 pandemic. This research will be carried out in the population of 3 maternity units in the Paris region carrying out a post-partum screening for perinatal depression based on the Edinburgh Postnatal Depression Depression Scale (EPDS) self-questionnaire. Secondary objectives include studying factors associated with the risk of developing depressive symptoms in the context of the COVID-19 pandemic. The 4 measurement times are 1) epidemic peak, 2) deconfinement phase, 3) at 2 months from deconfinement and 4) out of the pandemic context (1 year from peak) in order to constitute a control group of women not exposed to the pandemic context during pregnancy. Based on the prevalences of depressive disorders defined by an EPDS score > 10 reported in the literature, we were able to estimate the number of women to be included in the analysis at 545 women for each of the 4 phases in order to estimate the prevalence with a precision of +/- 3%, and to highlight a difference in prevalence of 7.5% with a power of 85% at 5% alpha risk. In total, for the 4 phases, 2180 women will therefore be included. Women will be included during hospitalisation in the post-natal suite or retrospectively for women who gave birth before the start of the study. The three participating maternity units are part of the same University Hospital Federation (FHU PREMA) and were chosen because of different population profiles, thus improving the representativeness of the sample. Individual data will be extracted from computer and paper records by automated processes for a number of variables and by clinical research assistants (TEC) for the others. Statistical analysis will be conducted within the UMR1153 EPOPé. This study, the only one to date capable of estimating the impact of the COVID-19 pandemic context on the risk of depressive disorders in the perinatal period, will provide a solid basis for constructing an appropriate response in the event of a second wave of COVID-19 or other epidemic episodes. Prevalence results for women who gave birth during phase 1 (available from July 2020) will provide information on the extent of the impact and the resources to be mobilized, in addition to the usual means. This study will also make it possible to identify the factors linked to the pandemic context (viral circulation, containment measures, restriction of access to hospital services for accompanying persons, length of hospital stay) most associated with the risk of depression, to offer antenatal psychological support to women most at risk and to adapt post-partum screening measures.

Endometriosis is a chronic hormone-dependent disease affecting 10% of women. Endocrine-disruptors have been suspected to play a role in endometriosis etiology, and several persistent organic pollutants (POPs) have been associated with endometriosis risk. However, despite experimental evidence of an impact of POPs on endometriosis lesion growth, no previous study has formally tested the hypothesis of an influence of POPs on the severity of endometriosis. POPENDO aims to examine associations between internal exposure levels of 4 families of POPs (dioxins, polychlorinated biphenyls, organochlorine pesticides, perfluorinated alkylated substances, totaling 81 substances) and endometriosis severity in a sample of 650 women participating in ComPaRe-Endometriosis, a prospective e-cohort of over 12,000 endometriosis patients. The findings will provide novel information on the impact of POP exposure on endometriosis that will contribute to inform prevention and reduce the impact of the disease.