Analysis of factors influencing postpartum depression in pregnant patients with heart disease and construction of a nomogram model
Objective To investigate the influencing factors of postpartum depression in pregnant women with heart dis-ease,and establish a nomogram model to quantify the contribution of each factor,in order to provide guidance for their postpartum recovery and management.Methods A total of 105 pregnant women with heart disease who visited and de-livered at the Maternal and Child Heart Disease Diagnosis and Treatment Center of the Northern Theater Command Gen-eral Hospital of the People's Liberation Army from July 2021 to July 2023 were included in the study.According to the scores of the Edinburgh Postnatal Depression Scale(EPDS)at 6 weeks after delivery,they were divided into the postpar-tum depression group(EPDS score＞9 points,n=48)and the no-postpartum depression group(EPDS score≤9 points,n=57).The Cardiac Anxiety Questionnaire(CAQ),European Heart Failure Self-Care Behavior Scale(EHFScBS),and self-made scale were used,combined with the patient's medical information,to assess their general data,heart disease,pregnancy,and newborn-related indicators.Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of postpartum depression in pregnant women with heart disease,and a nomogram model was estab-lished.Results The incidence of postpartum depression in pregnant women with heart disease was 45.71％(48/105).Univariate analysis showed that the gender and weight of the newborn,concern about the heart condition of the newborn,and specific items of the Cardiac Anxiety Questionnaire(Q3,Q4,Q13,Q15,Q16)had statistically significant differences between the postpartum depression group and the no-postpartum depression group.Multivariate Logistic regression analysis showed that female infants,concern about the heart condition of the newborn,and high scores on item Q15 of the Cardiac Anxiety Questionnaire were independent risk factors for postpartum depression in pregnant women with heart disease(P＜0.05).Internal validation results showed that the area under the curve of the nomogram model was 0.767(95％CI:0.679～0.856),with good discrimination and calibration.Decision curve analysis showed that when the threshold was between 0.08 and 0.68,the nomogram model provided clinical net benefits.Conclusions The in-cidence of postpartum depression in pregnant women with heart disease is high,and the risk factors are female newborns,concern about the heart condition of the newborn,and high scores on item Q15 of the Cardiac Anxiety Questionnaire.The nomogram model constructed on this basis can provide a reference for targeted management in clinical practice.
pregnancyheart diseasepostpartum depressionrisk factorsNomogram model
国家科技期刊平台
NSTL
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