A Predictive Model For Postpartum Depression And Its Application In Ketamine Intervention Population

Background: As we all know,postpartum depression is one of the most common mental and psychological diseases after delivery,and preventive intervention can significantly reduce the risk of postpartum depression.Therefore,identifying women with a high PPD risk and making a judgement as to the benefits of preventive intervention is a major challenge.Methods: This is a retrospective study of parturients that underwent a cesarean delivery.In the data of cesarean section parturient collected in Hunan Maternal and Child Health Hospital and the third Xiangya Hospital of Central South University between February 2014 and December 2019,311 parturients received ketamine intervention,and1004 parturients did not.The data that did not receive ketamine intervention were divided into development cohort and validation cohort,which were used to construct the prediction model of postpartum depression,test its prediction efficiency and determine the best risk threshold.After the risk classification of parturients,the data of the Control group and the Ketamine group were used to test whether there were differences in the incidence of postpartum depression between different risk groups.Results: The AUC for the development cohort and validation cohort of the PPD prediction model were 0.751(95%CI:0.700-0.802)and 0.748(95%CI:0.680-0.816),respectively.A threshold of 19% PPD risk probability was determined,the yoden index at this point was the largest,with a specificity and sensitivity in development cohort are 0.766 and0.604,respectively.After risk classification,the results demonstrated that PPD incidence significantly reduced in the high-risk group following ketamine,versus non-ketamine,intervention(P<0.05).In contrast,intervention in the low-risk group showed no significant difference in PPD outcomes(P>0.05).Conclusions: This prediction model developed in this study shows utility in predicting PPD risk.Ketamine intervention significantly lowers PPD incidence in parturients with a risk classification threshold greater than 19%.