Analysis of influencing factors and development of a nomogram prediction model for postpartum post-traumatic stress disorder in advanced-age primiparous women
Mao Lichao
Sun Dandan
Yin Yin
Li Yanli
Zhang Yangyang
Yan Wenye
Qian Xinyi
Abstract：Objective To investigate influencing factors for postpartum post-traumatic stress disorder(PTSD)in advanced-age primiparous women and develop a nomogram prediction model.Methods A total of 203 advanced-age primiparous women admit-ted to the First Affiliated Hospital with Nanjing Medical University from August 2023 to December 2024 were enrolled.At 6 weeks postpartum,follow-up questionnaires were administered,including a general information survey,PTSD Checklist-Civilian Version(PCL-C),Social Support Rating Scale(SSRS),and Connor-Davidson Resilience Scale(CD-RISC).A nomogram was constructed and internally validated using goodness-of-fit tests and calibration curves;receiver operating characteristic(ROC)curves were adopted to e-valuate the predictive performance of the model.Results The total PCL-C score was 29.46±3.57 points among these individu-als,with 31 cases(15.27％)scoring ≥38,indicating PTSD.SSRS and CD-RISC scores were 40.77±5.14 and 67.27±7.56 points,respectively.PCL-C scores negatively correlated with SSRS(r=-0.533;P＜0.05)and CD-RISC scores(r=-0.471;P＜0.05).Multivariate logistic step-wise regression analysis identified unemployment,poor sleep quality,and post-partum depression as risk factors,while SSRS and CD-RISC scores were protective factors for postpartum PTSD(P＜0.05).The nomogram achieved an area under the curve(AUC)of 0.903(95％CI:0.851-0.955)with 68.17％specificity and 91.45％sensitivity.Conclusion Employment status,sleep quality,postpartum depression,social support,and psychological resilience influence PTSD risk in advanced-age primiparas.The nomogram constructed based on these factors demonstrates strong predictive performance.
Keywords：PrimiparaAdvanced agePost-traumatic stress disorderInfluencing factorsNomogram
Publication Date：2025-07-20
Online Publishing Date：2025-11-19(First online date of this platform, not the publication date of the document)
Pages：7( 77-83 )