摘要
目的分析产后早期（1周内）EPDS分值对产后第4周、第8周产后抑郁的预测性，为早期实施预防性干预措施提供依据。方法应用EPDS量表和产妇一般情况调查表分别于产后第1周、第4周、第8周对159名产妇进行随访评估。用SPSS13．0统计分析软件对产后第1周EPDS分值的敏感度、特异度进行分析，并采用优势比和ROC曲线对预测值进行分析。结果产后第1周、第4周和第8周产妇中EPDS分值〉9分的分别占28．9％、30．2％、20．1％。以9／10为分界，产后第1周EPDS分值〉9分的产妇预测其在产后第4周、第8周发生产后抑郁的准确度分别达85．4％、82．5％，产后第1周内的EPDS分值与产后第4周（r=0．701，P〈0．01）、第8周（r=0．641，P〈0．01）的分值之间存在显著相关性，第1周EPDS分值〉9分同时EPDS分值〈13分的产妇在第4周（95％CI=22．438～184．720）和第8周（95％CI=2．759～11．709）发生产后抑郁的相对危险度将分别增加10．64倍和13．28倍。结论产后第1周内的EPDS分值能较准确地预测第4周、第8周产妇的情绪状态，产后早期采用EPDS量表进行常规筛选，以便及早实施干预措施，对预防和降低产后抑郁的发生率有重要的意义。
Objective predictive validation for postpartum depression at 4 and 8 weeks of EPDS scores at the 1 - week after delivery were analyzed such that preventive interventions may be implemented. Methods A population - based sample of 159 mothers completed the Edin- burgh Postnatal Depression Scale （EPDS） and general questionnaire respectively at 1,4 and 8 weeks postpartum. The sensitivity and specificity of the 1 - week EPDS in relation to identifying mothers with elevated EPDS scores at 4 and 8 weeks was determined with SPSS13.0 statistical analysis software. The predictive values of the 1 - week EPDS was further assessed using odds ratios and receiver operator characteristic （ROC） curves. Results At 1 ,4and 8 weeks postpartum, people of mothers scored 〉 9 on the EPDS were 28.9% ,30. 2% ,20. 1% respectively. Using the cut - off score of 9/10, the 1 - week EPDS 〉 9 分 accurately classified 85.4% mothers at 4 weeks and 82.5% mothers at 8 weeks with postpartum depression symptom. The 1 -week EPDS was significantly correlated to the 4 -week （r = 0. 701 ,P 〈 0. 01 ） and 8 -week （r = 0.641 ,P 〈 0. 01 ） EPDS. Mothers with a 1 - week EPDS score 〉 9 were 10.64 times more likely at 4 weeks （95% CI = 22. 438 - 184. 720） and 13.28 times more likely at 8 weeks （95% CI = 2. 759 - 11. 709） to exhibit postpartum depression symptom. Conclusions The EPDS administered in the 1 st week after delivery was prediction of maternal mood at 4 and 8 weeks more accurately. With EPDS routine screening in the immediate postpartum period such that secondary preventive interventions may be implemented, which is of major significance to prevent and reduce postpartum depression.
关键词
爱丁堡产后抑郁量表
产后抑郁
预测性
敏感度和特异度
Edinburgh Postnatal Depression Scale Postpartum depression Predictive validation Sensitivity and specificity
