Prevalence of postpartum post-traumatic stress disorder and its determinants in Mainland China: A systematic review and meta-analysis.

BACKGROUND: The prevalence and risk factors of postpartum posttraumatic stress disorder reported by population-based studies have significantly varied and the data are all collected from regional populations in Mainland China. AIMS: To utilize published data to estimate the overall prevalence of postpartum posttraumatic stress disorder and its determinants in Mainland China. METHODS: Comprehensively electronic searches were performed across six English databases and three Chinese databases. Random effects of the meta-analysis were performed to evaluate the pooled prevalence of postpartum posttraumatic stress disorder. Meta-regression was performed with the variable of study design, sample size, setting, measures, region, time points, and publication year. RESULTS: Totaling of nineteen studies was included, with a sample size of 13,231 postpartum women. The pooled prevalence of postpartum posttraumatic stress disorder was 11.2 % in Mainland China, with a higher prevalence at the timepoint within 1 month postpartum (18.1 %). Significant publication bias and heterogeneity were found (I2 = 97.1 %). Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder. Postpartum depressive symptoms, sleep problems, cesarean section, and low levels of social support were the major risk factors for postpartum posttraumatic stress disorder. While being the one child in the family was the protective factor. CONCLUSION: An increasing prevalence of posttraumatic stress disorder within one month postpartum significantly arises awareness to provide screening and more mental health services during this period. Screening programs for postpartum posttraumatic stress disorder are still needed in Mainland China.

Risk prediction for postpartum depression based on random forest / 中南大学学报(医学版)

OBJECTIVES@#To explore the application of random forest algorithm in screening the risk factors and predictive values for postpartum depression.@*METHODS@#We recruited the participants from a tertiary hospital between June 2017 and June 2018 in Changsha City, and followed up from pregnancy up to 4-6 weeks postpartum.Demographic economics, psychosocial, biological, obstetric, and other factors were assessed at first trimesters with self-designed obstetric information questionnaire and the Chinese version of Edinburgh Postnatal Depression Scale (EPDS). During 4-6 weeks after delivery, the Chinese version of EPDS was used to score depression and self-designed questionnaire to collect data of delivery and postpartum. The data of subjects were randomly divided into the training data set and the verification data set according to the ratio of 3꞉1. The training data set was used to establish the random forest model of postpartum depression, and the verification data set was used to verify the predictive effects via the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC index.@*RESULTS@#A total of 406 participants were in final analysis. Among them, 150 of whom had EPDS score ≥9, and the incidence of postpartum depression was 36.9%. The predictive effects of random forest model in the verification data set were at accuracy of 80.10%, sensitivity of 61.40%, specificity of 89.10%, positive predictive value of 73.00%, negative predictive value of 82.80%, and AUC index of 0.833. The top 10 predictive influential factors that screening by the variable importance measure in random forest model was antenatal depression, economic worries after delivery, work worries after delivery, free triiodothyronine in first trimesters, high-density lipoprotein in third trimester, venting temper to infants, total serum cholesterol and serum triglyceride in first trimester, hematocrit and serum triglyceride in third trimester.@*CONCLUSIONS@#Random forest has a great advantage in risk prediction for postpartum depression. Through comprehensive evaluation mechanism, it can identify the important influential factors for postpartum depression from complex multi-factors and conduct quantitative analysis, which is of great significance to identify the key factors for postpartum depression and carry out timely and effective intervention.

Research progress in prediction of postpartum depression / 中南大学学报(医学版)

Postpartum depression is a kind of mental disorder caused by the comprehensive effects of economics, psychosociology, biology, obstetrics and other characteristic factors in the process of female pregnancy. The pathogenesis of postpartum depression is complicated and has not been clarified. With the process pregnancy, the influence of psychosocial and biology factors are also in dynamic change. The postpartum depression predictor among psychosocial factors are antenatal depression, life events and social supports. Among biological factors, the predictors are hypothalamic-pituitary-thyroid axis and serum lipids. Timely and effective prediction can identify the high-risk population and risk factors for postpartum depression.

Development and Evaluation of an Online Training System for Home Caregivers.

With the increasing demands of professional rehabilitation training for home caregivers, to develop a mode of training with widespread applicability has been emphasized. In order to improve life quality of the impaired elderly, we developed an online training system for the home caregivers to learn knowledge and skills for caring the elderly. We also assessed the acceptance and acceptance factors of the online training system. The results showed that our training system was well accepted by the participants. The perceived usefulness and perceived ease of use were the dominant factors influencing the acceptance of the online course. Therefore, quality management and easy to use, rapid to capture the system are essential for the users to accept the training courses or health information better. An online training system with professional and standard protocols may be popular and well accepted for home caregivers.

The Investigation on Treatment Status of Sewage Discharged From Hospitals in Jinan / 环境与健康杂志

Objective To investigate the status of wastewater treatment of hospital sewage in Jinan. Methods The indices of COD, NH3,N and PO43- in sewage discharged from 16 hospitals before and after treatment and the content of residual chloride and fecal coliform counts in treated sewage were monitored in 2002 in Jinan. The monitoring results were evaluated according to the Criteria for Wastewater Discharge (GB/T8978-1996) and compared with the analytic results obtained in the year 2001. Results The COD, NH3,N and PO43- of the sewage of 16 hospitals before treatment were 253.8, 47.76 and 3.134 mg/L respectively with the over standard rate 81%, 88% and 100% respectively. The COD, NH3,N, PO43-, content of residual chloride and fecal coliform counts in treated sewage of 16 hospitals were 40.5, 6.30, 0.580, 26.7 mg/L and