Characteristics of patients with perinatal depression in UK primary care settings
Notice bibliographique
Résumé
Introduction Perinatal depression (PND) is a debilitating mood disorder that occurs during or following pregnancy. Information regarding characteristics associated with PND can aid in better understanding the disease. Objectives Examine patient characteristics and comorbidities of PND patients and matched non-PND controls in a UK electronic health record (EHR) database. Methods Women aged 12-55y with a delivery record (livebirth, stillbirth, mixed birth) during Jan 2017-Dec 2021 were selected from the Clinical Practice Research Datalink (CPRD) GOLD primary care database via a pregnancy algorithm. PND was ascertained using read codes during pregnancy or one year after the end of pregnancy date (EPD). Two ways to define PND were explored: 1) restricted definition (PND-r) where only PND codes were included; 2) broad definition (PND-b) including both PND and 34 other depression codes. For each PND case, two controls were matched on key patient variables such as age, depression history, and pregnancy outcome. Patients were required to have at least 12 months (mo) of continuous enrollment prior to and post EPD. Patient characteristics and select psychiatric and pregnancy-related comorbidities were compared, and prevalence rate ratios (PRR) and 95% Wald confidence intervals (CI) were calculated comparing cases and controls. Results The study included 2,214 cases of PND-r and 4,718 cases of PND-b, and their respective non-PND matched controls. PND-r and PND-b cases differed in timing of diagnosis. Of the PND-r cases, 6% were diagnosed during pregnancy and 47% in the first 3mo following delivery; whereas the distribution in the PND-b was, respectively, 18% and 30%. The mean age of the PND-r and PND-b cohorts was consistent (29y, SD=6). A prior recorded history of depression was present in 36% of PND-r cases and 43% of PND-b cases. Approximately 55% of PND-r cases and 65% of PND-b cases had a history of antidepressant use prior to last menstrual period. During the 12mo pre-EPD, PND-r cases had higher prevalence of hyperemesis gravidarum (PRR=1.5, 95% CI 1.3-1.8), gestational diabetes (PRR=1.4, 95% CI 1.1-1.7), and anxiety/panic disorders (PRR=1.8, 95% CI 1.3-2.3) compared to controls. During the 12mo post-EPD, PND-r cases had higher prevalence of comorbid anxiety/panic disorders (PRR=3.8, 95% CI 3.0-4.9) as well as post-traumatic stress disorder (PRR=3.1, 95% CI 1.5-6.1) compared to controls. Results were similar in the PPD-b analyses, but with higher PRR of anxiety/panic disorders (post-EPD PRR: 11.2, 95% CI 9.7-12.9). Conclusions 80% of PND-r and 71% of PND-b cases were diagnosed during pregnancy or in the first 6mo following EPD. Cases had higher prevalence of certain pregnancy and psychiatric conditions compared to controls, with comorbid anxiety/panic disorder estimates higher using the PND-b definition. Future research should consider comparing results using both broad and restricted definitions of PND in EHRs. Disclosure of Interest C. Gillis Shareolder of: Biogen, Employee of: Biogen, S. Chen Shareolder of: Biogen, Employee of: Biogen, C. Mak Shareolder of: Biogen, Employee of: Biogen, E. Tworkoski Shareolder of: Biogen, Employee of: Biogen, L. Li Shareolder of: Biogen, Employee of: Biogen, S. Eaton Shareolder of: Biogen, Employee of: Biogen, C. Green Shareolder of: Biogen, Employee of: Biogen, N. Maserejian Shareolder of: Biogen, Employee of: Biogen, M. Koch Shareolder of: Biogen, Employee of: Biogen.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».