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An optimization for postpartum depression risk assessment and preventive intervention strategy based machine learning

Hao Liu1, Anran Dai1, Zhou Zhou2

  • 1School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China; Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.

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Summary

This study developed a machine learning model to predict postpartum depression (PPD) risk in cesarean delivery patients. Early intervention significantly reduced PPD incidence in high-risk individuals identified by the model.

Keywords:
DexmedetomidineKetamineMachine learningPostpartum depressionPrediction modelRisk threshold

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Area of Science:

  • Obstetrics and Gynecology
  • Psychiatry
  • Medical Informatics

Background:

  • Postpartum depression (PPD) is a common psychiatric disorder affecting women after childbirth.
  • Effective PPD prediction models are crucial for identifying at-risk individuals and guiding clinical interventions.
  • Verifying the benefits of drug interventions for high-risk PPD groups is essential for clinical practice.

Purpose of the Study:

  • To develop and validate a machine learning model for predicting PPD risk in women undergoing cesarean delivery.
  • To assess the effectiveness of drug interventions (ketamine and dexmedetomidine) in reducing PPD incidence among high-risk and low-risk groups.
  • To interpret the prediction model using SHapley Additive exPlanations (SHAP) for clinical insights.

Main Methods:

  • Collected data from parturients undergoing cesarean delivery, divided into training and testing cohorts.
  • Constructed and compared six machine learning models, selecting Extreme Gradient Enhancement (XGB) for its performance.
  • Utilized SHapley Additive exPlanations (SHAP) for model interpretation and Propensity Score Matching (PSM) to compare intervention groups.

Main Results:

  • The XGB model achieved an AUROC of 0.789 in the training cohort and 0.744 in the testing cohort.
  • A PPD risk probability threshold of 21.5% was established to classify patients.
  • Post-PSM analysis revealed significantly lower PPD incidence in intervention groups compared to the control group within the high-risk cohort (P < 0.001).

Conclusions:

  • The XGB algorithm demonstrated superior accuracy in predicting PPD risk.
  • Early intervention is beneficial for high-risk individuals identified by the XGB model.
  • The study highlights the potential of machine learning in personalized PPD management.