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The development and application of a prediction model for postpartum depression: optimizing risk assessment and prevention in the clinic.
- Source :
-
Journal of Affective Disorders . Oct2021, Vol. 293, p434-442. 9p. - Publication Year :
- 2021
-
Abstract
- <bold>Background: </bold>Preventive intervention can significantly reduce the human and economic costs of postpartum depression (PPD) compared with treatment post-diagnosis. However, identifying women with a high PPD risk and making a judgement as to the benefits of preventive intervention is a major challenge.<bold>Methods: </bold>This is a retrospective study of parturients that underwent a cesarean delivery. Control group was used as development cohort and validation cohort to construct the risk prediction model of PPD and determine a risk threshold. Ketamine group and development cohort were used to verify the risk classification of parturients by evaluating whether the incidence of PPD decreased significantly after ketamine treatment in high-risk for PPD population.<bold>Results: </bold>The AUC for the development cohort and validation cohort of the PPD prediction model were 0.751 (95%CI:0.700-0.802) and 0.748 (95%CI:0.680-0.816), respectively. A threshold of 19% PPD risk probability was determined, with a specificity and sensitivity in the validation cohort are 0.766 and 0.604, respectively. After matching the high-risk group and the low-risk group by propensity score, the results demonstrated that PPD incidence significantly reduced in the high-risk group following ketamine, versus non-ketamine, intervention (p < 0.01). In contrast, intervention in the low-risk group showed no significant difference in PPD outcomes (p > 0.01).<bold>Limitation: </bold>Randomized trials are needed to further verify the feasibility of the model and the thresholds proposed.<bold>Conclusion: </bold>This prediction model developed in this study shows utility in predicting PPD risk. Ketamine intervention significantly lowers PPD incidence in parturients with a risk classification threshold greater than 19%. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01650327
- Volume :
- 293
- Database :
- Academic Search Index
- Journal :
- Journal of Affective Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 152988538
- Full Text :
- https://doi.org/10.1016/j.jad.2021.09.099