Risk factors for postpartum depression in pregnant women with allergic rhinitis: a retrospective study

Objective: Allergic rhinitis can cause symptoms to worsen after pregnancy and may cause problems such as postpartum depression. The goal of this study was to investigate the factors that influence postpartum depression in pregnant women with allergic rhinitis (AR). MethodsWe conducted a retrospective cohort study that included women with AR (based on self-reports) between June 2015 to June 2019 in Harvard University Partners Healthcare Systems (PARTNERS) in the USA. The study group was divided into postpartum depression and non-postpartum depression. Routine clinical and laboratory information was collected. Univariate and least absolute shrinkage and selection operator (LASSO, employed for predictor selection) regression analysis was used to study associations between AR during pollen seasons and adverse outcomes. Additionally, the receiver operating characteristic (ROC) curve evaluates discriminative ability by the area under the ROC curve (AUC). The calibration curve (DCA) was conducted to determine the clinical utility and benefit of the nomogram. Results A total of 216 pregnant women with AR participated in this study. Univariate analysis showed that 7 indicators were significantly different (P < 0.05). LASSO and multivariable regression identified four predictors to construct a nomogram for PPD in pregnant women with AR, the four selected risk predictors are as follows: pollen season pregnancy (OR = 1.514, 95%CI: 0.771-2.973), history of preterm birth (OR = 2.723, 95%CI: 1.157-6.406), number of pregnancies (OR = 2.104, 95%CI: 1.356-3.267), anti-allergy medication during pregnancy (OR = 2.975, 95%CI: 1.521-5.819). The nomogram displayed good discrimination, with AUC of 0.732 (95% CI: 0.657-0.808). The risk of postpartum depression increased with the increasing risk score of predictive nomogram. The calibration curve and DCA present optimal predictive power. Conclusions We highlighted the comorbidity of AR and postpartum depression, and suggested that a multidisciplinary consideration between allergists and obstetricians or midwives is needed to ensure that pregnant women consult experts to reduce AR symptoms. Trial registration number 2018P002646.