Munk-Olsen et al reported a model for predicting postpartum depression in a new mother. This can help to identify a mother who may require greater support. The authors are from University of Southern Denmark and multiple institutions in Denmark, Sweden and Canada.
Patient selection: postpartum
Exclusion: psychiatric history between birth and 6 months prior to conception
Parameters:
(1) mother's age in years
(2) cohabitation
(3) education
(4) previous psychiatric history
(5) postpartum hemorrhage
(6) gestational diabetes
(7) gestational hypertension
(8) preeclampsia
(9) eclampsia
(10) previous stillbirth
(11) previous abortion
(12) current acute cesarean section
(13) current preterm birth
(14) current hyperemesis gravidarum
|
Parameter |
Finding |
Points |
|
maternal age |
|
- |
|
cohabitation |
no |
0 |
|
|
yes |
0.04 |
|
education |
mandabory |
0.35 |
|
|
short |
0.15 |
|
|
medium |
-0.13 |
|
|
high |
0 |
|
psychiatric history |
none |
0 |
|
|
< 1 year |
exclusion criteria |
|
|
1-3 years before birth |
2.83 |
|
|
3-10 years before birth |
2.63 |
|
|
> 10 years before birth |
2.02 |
|
postpartum hemorrhage |
no |
0 |
|
|
yes |
0.35 |
|
gestational diabetes |
no |
0 |
|
|
yes |
0.30 |
|
gestational hypertension |
no |
0 |
|
|
yes |
0.20 |
|
preeclampsia |
no |
0 |
|
|
yes |
0.15 |
|
eclampsia |
no |
0 |
|
|
yes |
0.36 |
|
previous stillbirth |
no |
0 |
|
|
yes |
-0.32 |
|
previous abortion |
no |
0 |
|
|
yes |
-0.01 |
|
acute cesarean section |
no |
0 |
|
|
yes |
0.20 |
|
preterm birth |
no |
0 |
|
|
yes |
0.32 |
|
hyperemesis gravidarum |
no |
0 |
|
|
yes |
0.56 |
where:
• Gestational hypertension, preeclampsia and eclampsia appear to be viewed as separate.
value of X =
= SUM(points for all of the parameters) - 2.82
probability of post-partum depression =
= 1 / (1 + EXP((-1) * X))
Performance:
• In the validation cohort the sensitivity was 0.87 and specificity 0.69.
The report also contains a nomogram for the model.
Specialty: Psychiatry
