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基于机器学习的三波随访研究:中国女性产后抑郁症轨迹及其风险预测模型。

Trajectory on postpartum depression of Chinese women and the risk prediction models: A machine-learning based three-wave follow-up research.

机构信息

Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.

West China School of Nursing, Sichuan University, China.

出版信息

J Affect Disord. 2024 Nov 15;365:185-192. doi: 10.1016/j.jad.2024.08.074. Epub 2024 Aug 16.

Abstract

BACKGROUND

Our study delves into postpartum depression (PPD) extending observation up to six months postpartum, addressing the gap in long-term follow-ups and uncover critical intervention points.

METHOD

Through a continuous three-wave cohort study involving 3174 of 10,730 invited postpartum women, we utilized machine learning to predict PPD risk, incorporating self-reported surveys and health records from October 2021 to Jan 2023.

RESULTS

PPD prevalence slightly decreased from 30.9 % to 29.1 % over six months. The Random Forest model emerged as the most effective, identifying key predictors of PPD at different stages. The top three factors at first month were newborn's birth weight, maternal weight before delivery and before pregnancy. The EPDS scores of last time, newborn's birth weight and maternal weight before pregnancy and before delivery were main predictors for EPDS scores at third and sixth months postpartum.

LIMITATION

The study faces limitations such as potential selection bias due to the convenience sampling method and the reliance on self-reported measures, which may introduce reporting bias. Furthermore, the high attrition rate could affect the representativeness of the sample and the generalizability of the findings.

CONCLUSION

There is a slight decrease in PPD rates over six months, yet the prevalence remains high. This underscores the need for early and ongoing mental health support for new mothers. Our study highlights the efficacy of machine learning in enhancing PPD risk assessment and tailoring intervention strategies, paving the way for more personalized healthcare approaches in postpartum care.

摘要

背景

我们的研究深入探讨了产后抑郁症(PPD),将观察时间延长至产后六个月,填补了长期随访的空白,并揭示了关键的干预点。

方法

通过一项连续的三波队列研究,涉及 10730 名受邀产后女性中的 3174 名,我们利用机器学习预测 PPD 风险,结合了 2021 年 10 月至 2023 年 1 月期间的自我报告调查和健康记录。

结果

PPD 的患病率在六个月内从 30.9%略微下降到 29.1%。随机森林模型是最有效的模型,它在不同阶段识别了 PPD 的关键预测因素。第一个月的前三个因素是新生儿的出生体重、产妇分娩前的体重和孕前体重。最后一次的 EPDS 评分、新生儿的出生体重以及产妇分娩前和孕前的体重是产后第三个和第六个月 EPDS 评分的主要预测因素。

局限性

该研究存在一些局限性,例如由于方便抽样方法可能存在选择偏倚,以及依赖自我报告的措施可能引入报告偏倚。此外,高流失率可能会影响样本的代表性和研究结果的普遍性。

结论

PPD 率在六个月内略有下降,但患病率仍然很高。这突显了需要为新妈妈提供早期和持续的心理健康支持。我们的研究强调了机器学习在增强 PPD 风险评估和定制干预策略方面的有效性,为产后护理中更个性化的医疗保健方法铺平了道路。

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