Analysis of factors related to postpartum depression in pregnancy-induced hypertension syndrome patients and construction and evaluation of nomograms

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 χ(2) = 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.