Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, 13600 Ciudad Real, Spain.
Nursing Department, University of Jaen, 23071 Jaen, Spain.
Int J Environ Res Public Health. 2020 Dec 24;18(1):92. doi: 10.3390/ijerph18010092.
This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of 1752 women (2/3) and were validated on a cohort of 875 women (1/3). The predictive factors in model A were delivery type, skin-to-skin contact, admission of newborn to care unit, presence of a severe tear, type of infant feeding at discharge, postpartum hospital readmission. The area under curve (AUC) of the receiver operating characteristic (ROC) in the referral cohort was 0.70 (95% CI: 0.67-0.74), while in the validation cohort, it was 0.69 (95% CI: 0.63-0.75). The predictive factors in model B were delivery type, admission of newborn to care unit, type of infant feeding at discharge, postpartum hospital readmission, partner support, and the perception of adequate respect from health professionals. The predictive capacity of model B in both the referral cohort and the validation cohort was superior to model A with an AUC-ROC of 0.82 (95% CI: 0.79-0.85) and 0.83 (95% CI: 0.78-0.87), respectively. A predictive model (model B) formed by clinical variables and the perception of partner support and appropriate treatment by health professionals had a good predictive capacity in both the referral and validation cohorts. This model is preferred over the model (model A) that was formed exclusively by clinical variables.
本研究旨在使用 2018 年至 2019 年期间在西班牙分娩的女性回顾性队列研究,开发和验证两种产后创伤后应激障碍(PTSD)风险的预测模型。使用转诊队列中的 1752 名女性(2/3)开发预测模型,并在 875 名女性(1/3)的队列中进行验证。模型 A 的预测因素包括分娩方式、皮肤接触、新生儿入住护理单元、严重撕裂、出院时婴儿喂养方式、产后住院再入院。转诊队列中接受者操作特征(ROC)曲线下面积(AUC)为 0.70(95%CI:0.67-0.74),而验证队列中为 0.69(95%CI:0.63-0.75)。模型 B 的预测因素包括分娩方式、新生儿入住护理单元、出院时婴儿喂养方式、产后住院再入院、伴侣支持以及对卫生专业人员充分尊重的感知。模型 B 在转诊队列和验证队列中的预测能力均优于模型 A,AUC-ROC 分别为 0.82(95%CI:0.79-0.85)和 0.83(95%CI:0.78-0.87)。由临床变量和对伴侣支持以及卫生专业人员适当治疗的感知组成的预测模型(模型 B)在转诊和验证队列中均具有良好的预测能力。该模型优于仅由临床变量组成的模型(模型 A)。