ArticleInternational journal of women's health2026
Development and Internal Validation of a Psychosocial Nomogram for Antenatal Depressive Symptoms in Third-Trimester Pregnant Women at a Regional Hospital in Southern Vietnam.
Article in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Antenatal depression is common and under-recognized, yet few individualized tools exist to support its identification in obstetric practice in low- and middle-income countries. We estimated the prevalence of a positive antenatal depression screen among third-trimester pregnant women in southern Vietnam and developed and internally validated a psychosocial nomogram for the concurrent probability of a positive screen. Patients and Methods: Within a prospective study at Long Khanh Regional General Hospital (July 2025 to May 2026), 968 women at 28 weeks of gestation or later were screened with a Vietnamese-language version of the Edinburgh Postnatal Depression Scale (EPDS; positive screen defined as a score ≥13). Sociodemographic, obstetric, marital, family, and social variables were recorded at the same visit, so predictors and outcome were measured concurrently (a diagnostic rather than a prognostic model). Candidate predictors with p<0.25 in univariable logistic regression entered a multivariable model reduced by backward elimination (p<0.05). Results: The prevalence of a positive screen was 16.5% (160/968; 95% CI 14.3-19.0). Six variables were retained in the final model: an adverse family event (adjusted odds ratio [aOR] 5.25), marital conflict (aOR 3.64), a family history of depression (aOR 2.76), neighbourhood or workplace conflict (aOR 2.48), work-related pressure (aOR 2.22), and a lack of psychosocial support (aOR 1.77). Apparent discrimination was good (area under the curve 0.807, 95% CI 0.769-0.847) and fell to an optimism-corrected 0.782 after bootstrapping the full procedure; the optimism-corrected calibration slope was 0.88 and calibration-in-the-large was near zero. On decision curve analysis the nomogram gave a higher net benefit than screening all women at threshold probabilities above about 10%. Conclusion: About one in six third-trimester women screened positive for depressive symptoms. A nomogram based on six readily recorded psychosocial variables showed good apparent and promising internally validated performance and may support psychosocial risk stratification where universal formal screening is difficult.
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