Volume 11,Issue 3
Analysis of Factors Influencing Post-Traumatic Stress Disorder in Patients with Failed Assisted Reproductive Technology (ART) Pregnancy Outcomes and Development of a Predictive Model
Objective: To investigate the prevalence of posttraumatic stress disorder (PTSD) among patients who experienced pregnancy failure following assisted reproductive technology (ART) treatment, analyze the factors influencing PTSD, and develop a risk prediction model. Methods: A cross-sectional study was conducted, recruiting 243 patients who experienced pregnancy failure after ART treatment at a tertiary-level specialized reproductive hospital. Data were collected using general demographic information, clinical records, the Infertile Women’s Motivation for Childbearing Scale, the Brief Infertility Stress Scale, the Perceived Social Support Scale, and the posttraumatic stress disorder (PTSD) scale (Civilians Version). Patients were classified into PTSD and non-PTSD groups based on PTSD scale scores. Univariate analysis (Mann-Whitney U test and chi-square tests) was used to screen variables, and a multivariate binary logistic regression model was constructed to predict PTSD. The ROC curve was used to evaluate the model’s discriminatory ability. Results: Among 243 patients with failed ART pregnancies, 40 developed PTSD, the positive screening rate for PTSD was 16.46%. Univariate analysis revealed statistically significant differences in PTSD incidence based on household income, number of failed ART pregnancies, presence of children, fertility stress, fertility motivation and social support (P < 0.05). Logistic regression analysis indicated that having no children, two failed ART pregnancies, and fertility stress were risk factors for PTSD in patients with failed ART pregnancies, while social support was a protective factor. The area under the receiver operating characteristic (ROC) curve (AUC) of the constructed risk prediction model was 0.869 (95% CI [0.813, 0.924]), indicating good predictive performance, with a sensitivity of 85.0%, a specificity of 74.4%, and a cutoff value of 0.138. Conclusion: Having no children, two failed ART pregnancies, and fertility stress are risk factors for PTSD in patients with failed ART pregnancies. The predictive model established based on these identified risk factors can be used to assess the risk of PTSD in patients with failed ART pregnancies.
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