确定心理社会预测因素,并制定肯尼亚孕妇早产风险评分
Anna Larsen1,2, Jillian Pintye3,4, Felix Abuna5
1Department of Epidemiology, University of Washington, 3980 15th Ave NE, Box 351619, Seattle, WA, 98195, USA. annalar@uw.edu.
BMC pregnancy and childbirth
|January 3, 2025
概括
在肯尼亚,早产 (PTB) 影响了19%的怀孕. 虽然结合亲密伴侣暴力和抑郁症等社会因素的风险得分显示出适度的预测,但将心理健康服务纳入产前护理可能会改善结果.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 早产 (PTB) 是新生儿死亡的主要原因,特别是在撒哈拉以南非洲.
- 这项研究的重点是确定和结合与肯尼亚妇女PTB相关的人口,临床和心理社会因素.
研究的目的:
- 利用人口,临床和心理社会因素,制定预测早产风险评分 (PTB).
- 评估分数在肯尼亚队列中歧视和校准PTB风险的能力.
主要方法:
- 在肯尼亚西部的20家产前诊所对4084名HIV阴性妇女进行前性研究.
- 评估了抑郁症状 (CESD-10),亲密伴侣暴力 (IPV,HITS) 和社会支持 (MOS-SSS).
- 使用多变量Cox模型和k-fold交叉验证来开发和验证风险评分.
主要成果:
- 19%的怀孕导致PTB (70.9每100胎年).
- 关键预测因素包括未婚,低学历,IPV,较高的抑郁症状和较低的社会支持.
- 最终的风险评分 (未婚状态,社会支持,IPV,抑郁症状) 显示了适度的歧视 (AUROC:0.56).
- 与低风险女性相比,高风险女性患PTB的风险高出40%.
结论:
- PTB与可接受干预的社会因素有显著的关联.
- 结合这些因素的风险评分具有有限的预测能力,凸显了PTB的多因素性质.
- 将心理健康和支持服务纳入产前护理可能为更好地了解和管理PTB风险提供了一条途径.
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