目的 探讨顺产产妇疼痛评分与产后抑郁的相关性，并构建产后抑郁风险预测模型。 方法 选取2019年10月至2020年10月在济南市中心医院分娩的顺产产妇1 000例，根据爱丁堡产后抑郁量表(Edinburgh postnatal depression scale，EPDS)进行产后抑郁评分，并将产妇分为抑郁组和正常组。比较两组产妇的顺产疼痛评分、年龄、职业、教育程度、家庭平均月收入、分娩孕周、喂养方式、丈夫对胎儿的期望、夫妻关系、居住关系、睡眠质量、焦虑抑郁病史、新生儿不良结局、性格、孕期负性情绪等一般资料情况，采用Pearson相关性分析顺产疼痛评分与产后抑郁的相关性，多因素Logistic回归分析顺产产妇产后抑郁的风险因素，构建预测模型并绘制ROC曲线以分析其对顺产产妇产后抑郁的预测价值。采用R软件构建顺产产妇产后抑郁风险的列线图模型。 结果 EPDS评分显示，产后抑郁产妇为100例，占比10。00%。两组产妇VAS评分、年龄、教育程度、家庭平均月收入、分娩孕周、喂养方式、夫妻关系、睡眠质量、焦虑抑郁病史、新生儿不良结局、性格、孕期负性情绪、职业比较，差异有统计学意义(P<0。05)。VAS评分与顺产产妇产后抑郁呈正相关(P<0。05)。非条件Logistic回归分析显示，VAS评分、年龄、教育程度、分娩孕周、喂养方式、夫妻关系、睡眠质量、焦虑抑郁病史、新生儿不良结局、性格、职业等均为顺产产妇产后抑郁的独立影响因素(P<0。05)。模型1(VAS评分＋年龄＋教育程度＋分娩孕周＋喂养方式＋夫妻关系＋睡眠质量＋焦虑抑郁病史＋新生儿不良结局＋性格)预测顺产产妇产后抑郁的ROC曲线下面积为91。3%(95CI：73。3%～97。6%)，模型2(年龄＋教育程度＋分娩孕周＋喂养方式＋夫妻关系＋睡眠质量＋焦虑抑郁病史＋新生儿不良结局＋性格)预测顺产产妇产后抑郁的ROC曲线下面积为78。6%(95CI：64。2%～88。2%)。 结论 顺产疼痛评分与产后抑郁呈正相关，并且顺产疼痛评分参与构建的预测模型对顺产产妇产后抑郁具有较高的预测价值。 Objective To explore the correlation between pain scores and postpartum depression of parturients with natural labor， and to construct a risk prediction model for postpartum depression。 Methods A total of 1 000 parturients who gave birth in the hospital from October 2019 to October 2020 were selected。According to the Edinburgh Postnatal Depression Scale (EPDS)， the postpartum depression score was performed， and the parturients were included in the depression group and the normal group。The pain score， age， occupation， education level， average monthly family income， gestational week of delivery， feeding method， husband's expectation of the fetus， husband and wife relationship， residential relationship， sleep quality， history of anxiety and depression， adverse neonatal outcomes， personality， negative emotions during pregnancy were compared。Pearson correlation analysis was used to analyze the correlation between vaginal pain score and postpartum depression。 Multivariate Logistic regression was used to analyze the risk factors of postpartum depression in vaginal parturients。 The predictive model was constructed and ROC curve was drawn to analyze its predictive value for postpartum depression in vaginal parturients。The R software was used to construct a nomogram model of the risk of postpartum depression of parturients with natural labor。 Results EPDS score showed that there were 100 cases of postpartum depression， accounting for 10。00%。There were statistically significant differences in Visual Analogue Scale(VAS) score， age， education level， average monthly family income， gestational weeks， feeding patterns， marital relationship， sleep quality， history of anxiety and depression， adverse neonatal outcomes， personality， negative emotions during pregnancy and occupation between the two groups (P<0。05)。 The VAS score was positively correlated with postpartum depression of the parturients with natural labor (P<0。05)。 Unconditional Logistic regression analysis showed that VAS score， age， education level， gestational week of delivery， feeding method， husband and wife relationship， sleep quality， history of anxiety and depression， adverse neonatal outcomes， personality， profession were independent influencing factors of postpartum depression of parturients with natural labor (P<0。05)。 Model 1 (VAS score + age + education level + gestational week of delivery + feeding method + husband and wife relationship + sleep quality+ history of anxiety and depression + adverse neonatal outcomes+ personality) predicts the area under the ROC curve of postpartum depression of parturients with natural labor was 91。3% (95CI: 73。3%~97。6%)。 Model 2 (age + education level + gestational week of delivery + feeding method + husband and wife relationship + sleep quality+ history of anxiety and depression + adverse neonatal outcomes+ personality) predicts the area under the ROC curve of postpartum depression of parturients with natural labor was 78。6% (95CI: 64。2%~88。2%)。 Conclusions There is a positive correlation between the postpartum depression score and the postpartum depression， and the predictive model constructed by the postpartum pain score has a high predictive value for the postpartum depression of parturients with natural labor。
Correlation between pain score and postpartum depression of parturients with natural labor and construction of a risk model for postpartum depression
Objective To explore the correlation between pain scores and postpartum depression of parturients with natural labor, and to construct a risk prediction model for postpartum depression. Methods A total of 1 000 parturients who gave birth in the hospital from October 2019 to October 2020 were selected.According to the Edinburgh Postnatal Depression Scale (EPDS), the postpartum depression score was performed, and the parturients were included in the depression group and the normal group.The pain score, age, occupation, education level, average monthly family income, gestational week of delivery, feeding method, husband's expectation of the fetus, husband and wife relationship, residential relationship, sleep quality, history of anxiety and depression, adverse neonatal outcomes, personality, negative emotions during pregnancy were compared.Pearson correlation analysis was used to analyze the correlation between vaginal pain score and postpartum depression. Multivariate Logistic regression was used to analyze the risk factors of postpartum depression in vaginal parturients. The predictive model was constructed and ROC curve was drawn to analyze its predictive value for postpartum depression in vaginal parturients.The R software was used to construct a nomogram model of the risk of postpartum depression of parturients with natural labor. Results EPDS score showed that there were 100 cases of postpartum depression, accounting for 10.00%.There were statistically significant differences in Visual Analogue Scale(VAS) score, age, education level, average monthly family income, gestational weeks, feeding patterns, marital relationship, sleep quality, history of anxiety and depression, adverse neonatal outcomes, personality, negative emotions during pregnancy and occupation between the two groups (P<0.05). The VAS score was positively correlated with postpartum depression of the parturients with natural labor (P<0.05). Unconditional Logistic regression analysis showed that VAS score, age, education level, gestational week of delivery, feeding method, husband and wife relationship, sleep quality, history of anxiety and depression, adverse neonatal outcomes, personality, profession were independent influencing factors of postpartum depression of parturients with natural labor (P<0.05). Model 1 (VAS score + age + education level + gestational week of delivery + feeding method + husband and wife relationship + sleep quality+ history of anxiety and depression + adverse neonatal outcomes+ personality) predicts the area under the ROC curve of postpartum depression of parturients with natural labor was 91.3% (95CI: 73.3%~97.6%). Model 2 (age + education level + gestational week of delivery + feeding method + husband and wife relationship + sleep quality+ history of anxiety and depression + adverse neonatal outcomes+ personality) predicts the area under the ROC curve of postpartum depression of parturients with natural labor was 78.6% (95CI: 64.2%~88.2%). Conclusions There is a positive correlation between the postpartum depression score and the postpartum depression, and the predictive model constructed by the postpartum pain score has a high predictive value for the postpartum depression of parturients with natural labor.
Natural laborPain scorePostpartum depressionCorrelationPredictive model
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