Hsu Fu-Mei, Chen Hsiu-Chin, Wang Kuei-Ching, Ling Wan-Ling, Chen Nai-Ching
Department of Nursing, Chi Mei Medical Center, No. 901, Zhonghua Road, Yongkang District, Tainan, 71004, Taiwan.
Chi Mei Medical Center, No. 901, Zhonghua Road, Yongkang District, Tainan, 71004, Taiwan.
Arch Womens Ment Health. 2024 Oct 5. doi: 10.1007/s00737-024-01521-6.
This study aimed to explore the dynamic changes in postpartum depressive symptoms from the hospitalization period to 4-8 weeks postpartum using time series analysis techniques. By integrating depressive scores from the hospital stay and the early postpartum weeks, we sought to develop a predictive model to enhance early identification and intervention strategies for Postpartum Depression (PPD).
A longitudinal design was employed, analyzing Edinburgh Postnatal Depression Scale (EPDS) scores from 1,287 postpartum women during hospitalization and at 4, 6, and 8 weeks postpartum. Descriptive statistics summarized demographic characteristics. Time Series Analysis using the Auto-Regressive Integrated Moving Average (ARIMA) model explored temporal trends and seasonal variations in EPDS scores. Correlation analysis examined the relationships between EPDS scores and demographic characteristics. Model validation was conducted using a separate dataset.
EPDS scores significantly increased from the hospitalization period to 4-8 weeks postpartum (p < .001). The ARIMA model revealed seasonal and trend variations, with higher depressive scores in the winter months. The model's fit indices (AIC = 765.47; BIC = 774.58) indicated a good fit. The Moving Average (MA) coefficient was - 0.69 (p < .001), suggesting significant negative impacts from previous periods' errors.
Monitoring postpartum depressive symptoms dynamically was crucial, particularly during the 4-8 weeks postpartum. The seasonal trend of higher depressive scores in winter underscored the need for tailored interventions. Further research using longitudinal and multi-center designs was warranted to validate and extend these findings. Our predictive model aimed to enhance early identification and intervention strategies, contributing to better maternal and infant health outcomes.
本研究旨在运用时间序列分析技术,探讨产后抑郁症状从住院期到产后4 - 8周的动态变化。通过整合住院期间和产后早期的抑郁评分,我们试图建立一个预测模型,以加强产后抑郁症(PPD)的早期识别和干预策略。
采用纵向设计,分析1287名产后妇女在住院期间以及产后4周、6周和8周时的爱丁堡产后抑郁量表(EPDS)评分。描述性统计总结了人口统计学特征。使用自回归积分移动平均(ARIMA)模型进行时间序列分析,以探索EPDS评分的时间趋势和季节性变化。相关性分析检验了EPDS评分与人口统计学特征之间的关系。使用单独的数据集进行模型验证。
从住院期到产后4 - 8周,EPDS评分显著增加(p <.001)。ARIMA模型显示出季节性和趋势变化,冬季的抑郁评分更高。该模型的拟合指数(AIC = 765.47;BIC = 774.58)表明拟合良好。移动平均(MA)系数为 - 0.69(p <.001),表明前一时期的误差有显著负面影响。
动态监测产后抑郁症状至关重要,尤其是在产后4 - 8周期间。冬季抑郁评分较高的季节性趋势突出了进行针对性干预的必要性。有必要采用纵向和多中心设计进行进一步研究,以验证和扩展这些发现。我们的预测模型旨在加强早期识别和干预策略,有助于改善母婴健康结局。