产前抑郁症状预后工具的开发和验证：整合自我报告和生物标志物测量的两阶段模型的统计分析计划

Background: Antenatal depression is common, under-detected, and harms mothers and infants. Pakistan has Asia’s highest perinatal depression prevalence and an estimated national economic burden of US$16.5 billion. About 9.7 million Pakistani women become pregnant each year, and roughly 3.6 million may experience antenatal depression. Routine detection relies on self-report scales (e.g., Edinburgh Postnatal Depression Scale [EPDS]); whether biomarkers add prognostic value is largely untested. Objective: Develop and validate a multivariable prognostic tool (MPT) to predict clinically significant