Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2023; 13(9): 654-664
Published online Sep 19, 2023. doi: 10.5498/wjp.v13.i9.654
Analysis of factors related to postpartum depression in pregnancy-induced hypertension syndrome patients and construction and evaluation of nomograms
Jie-Wei Pan, Gang Zhao
Jie-Wei Pan, Gang Zhao, Department of Obstetrics and Gynecology, Huzhou Maternity and Child Health Care Hospital, Huzhou 313000, Zhejiang Province, China
Author contributions: Pan JW designed and performed the research and wrote the paper; Zhao G designed the research and supervised the report.
Supported by Medical Health Science and Technology Project of Huzhou City, No. 2021GY01.
Institutional review board statement: The study was reviewed and approved by the Huzhou Maternity & Child Health Care Hospital, No. 2023-J-060.
Informed consent statement: Approved and exempted from informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gang Zhao, MBBS, Attending Doctor, Department of Obstetrics and Gynecology, Huzhou Maternity and Child Health Care Hospital, No. 2 East Street, Yuehe Street, Wuxing District, Huzhou 313000, Zhejiang Province, China. zhaogang0572@163.com
Received: June 30, 2023
Peer-review started: June 30, 2023
First decision: July 18, 2023
Revised: July 25, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 19, 2023
Processing time: 77 Days and 1.4 Hours
Abstract
BACKGROUND

It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect high-risk patients as early as possible, which has application value for the clinical development of personalized prevention programs and prognosis of patients.

AIM

To analyze factors related to postpartum depression in patients with pregnancy-induced hypertension and construct and evaluate a nomogram model.

METHODS

The clinical data of 276 patients with pregnancy-induced hypertension admitted to Huzhou Maternity and Child Health Care Hospital between January 2017 and April 2022 were retrospectively analyzed. We evaluated the depression incidence at 6 wk postpartum. The depression group included patients with postpartum depression, and the remainder were in the non-depression group. Multivariate logistic regression analysis and the LASSO regression model were applied to analyze the factors related to postpartum depression in patients with pregnancy-induced hypertension. After that, a risk prediction model nomogram was constructed and evaluated.

RESULTS

Multivariate logistic regression analysis showed that vitamin A deficiency (VAD) during pregnancy and puerperium, family history of hypertension, maternal intestinal flora imbalance, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were independent risk factors for postpartum depression in patients with pregnancy-induced hypertension (P < 0.05). We constructed the nomogram model based on these five risk factors. The area under the curve, specificity, and sensitivity of the model in predicting postpartum depression in patients with pregnancy-induced hypertension was 0.867 (95% confidence interval: 0.828–0.935), 0.676, and 0.889, respectively. The average absolute error was 0.037 (Hosmer-Lemeshow test χ2 = 10.739, P = 0.217).

CONCLUSION

VAD during pregnancy and puerperium, family history of hypertension, maternal intestinal flora imbalance, EPA, and DHA affect postpartum depression in patients with pregnancy-induced hypertension.

Keywords: Pregnancy-induced hypertension syndrome; Postpartum depression; Unhealthy emotions; Related factors; Nomograms; Evaluation

Core Tip: Pregnancy-induced hypertension usually manifests as an elevation of blood pressure, oedema, multiple organ damage, eclampsia, and even coma. Here, we analyzed the factors related to postpartum depression in patients with pregnancy-induced hypertension. We used vitamin A deficiency during pregnancy and puerperium, family history of hypertension, maternal intestinal flora imbalance, eicosapentaenoic acid, and docosahexaenoic acid to construct a nomogram evaluated and confirmed to have good predictive performance. It is a breakthrough in the prediction of postpartum depression in pregnancy-induced hypertension.