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      Machine learning techniques for predicting depression and anxiety in pregnant and postpartum women during the COVID-19 pandemic: a cross-sectional regional study

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          Abstract

          Background: Maternal depression and anxiety are significant public health concerns that play an important role in the health and well-being of mothers and children. The COVID-19 pandemic, the consequential lockdowns and related safety restrictions worldwide negatively affected the mental health of pregnant and postpartum women.

          Methods: This regional study aimed to develop a machine learning (ML) model for the prediction of maternal depression and anxiety. The study used a dataset collected from five Arab countries during the COVID-19 pandemic between July to December 2020. The population sample included 3569 women (1939 pregnant and 1630 postpartum) from five countries (Jordan, Palestine, Lebanon, Saudi Arabia, and Bahrain). The performance of seven machine learning algorithms was assessed for the prediction of depression and anxiety symptoms.

          Results: The Gradient Boosting (GB) and Random Forest (RF) models outperformed other studied ML algorithms with accuracy values of 83.3% and 83.2% for depression, respectively, and values of 82.9% and 81.3% for anxiety, respectively. The Mathew’s Correlation Coefficient was evaluated for the ML models; the Naïve Bayes (NB) and GB models presented the highest performance measures (0.63 and 0.59) for depression and (0.74 and 0.73) for anxiety, respectively. The features’ importance ranking was evaluated, the results showed that stress during pregnancy, family support, financial issues, income, and social support were the most significant values in predicting anxiety and depression.

          Conclusion: Overall, the study evidenced the power of ML models in predicting maternal depression and anxiety and proved to be an efficient tool for identifying and predicting the associated risk factors that influence maternal mental health. The deployment of machine learning models for screening and early detection of depression and anxiety among pregnant and postpartum women might facilitate the development of health prevention and intervention programs that will enhance maternal and child health in low- and middle-income countries.

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          Most cited references34

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic

            Background Anxiety and depression symptoms in pregnancy typically affect between 10-25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. Methods We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support. Results We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms. Conclusion This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.
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              Multi-modal multi-task learning for joint prediction of multiple regression and classification variables in Alzheimer's disease.

              Many machine learning and pattern classification methods have been applied to the diagnosis of Alzheimer's disease (AD) and its prodromal stage, i.e., mild cognitive impairment (MCI). Recently, rather than predicting categorical variables as in classification, several pattern regression methods have also been used to estimate continuous clinical variables from brain images. However, most existing regression methods focus on estimating multiple clinical variables separately and thus cannot utilize the intrinsic useful correlation information among different clinical variables. On the other hand, in those regression methods, only a single modality of data (usually only the structural MRI) is often used, without considering the complementary information that can be provided by different modalities. In this paper, we propose a general methodology, namely multi-modal multi-task (M3T) learning, to jointly predict multiple variables from multi-modal data. Here, the variables include not only the clinical variables used for regression but also the categorical variable used for classification, with different tasks corresponding to prediction of different variables. Specifically, our method contains two key components, i.e., (1) a multi-task feature selection which selects the common subset of relevant features for multiple variables from each modality, and (2) a multi-modal support vector machine which fuses the above-selected features from all modalities to predict multiple (regression and classification) variables. To validate our method, we perform two sets of experiments on ADNI baseline MRI, FDG-PET, and cerebrospinal fluid (CSF) data from 45 AD patients, 91 MCI patients, and 50 healthy controls (HC). In the first set of experiments, we estimate two clinical variables such as Mini Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), as well as one categorical variable (with value of 'AD', 'MCI' or 'HC'), from the baseline MRI, FDG-PET, and CSF data. In the second set of experiments, we predict the 2-year changes of MMSE and ADAS-Cog scores and also the conversion of MCI to AD from the baseline MRI, FDG-PET, and CSF data. The results on both sets of experiments demonstrate that our proposed M3T learning scheme can achieve better performance on both regression and classification tasks than the conventional learning methods. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal AnalysisRole: MethodologyRole: Project AdministrationRole: ValidationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: Data CurationRole: Software
                Role: Data CurationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: Data CurationRole: InvestigationRole: Project AdministrationRole: Supervision
                Role: Data Curation
                Role: ConceptualizationRole: Data CurationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: MethodologyRole: Project AdministrationRole: Writing – Review & Editing
                Role: Data CurationRole: Project Administration
                Role: ConceptualizationRole: Data CurationRole: Methodology
                Role: Data CurationRole: Supervision
                Role: ConceptualizationRole: Data CurationRole: MethodologyRole: Project Administration
                Role: Data CurationRole: Investigation
                Role: ConceptualizationRole: Project Administration
                Role: Data CurationRole: Supervision
                Role: ConceptualizationRole: Data CurationRole: InvestigationRole: MethodologyRole: Project AdministrationRole: Writing – Review & Editing
                Journal
                F1000Res
                F1000Res
                F1000Research
                F1000 Research Limited (London, UK )
                2046-1402
                4 April 2022
                2022
                : 11
                : 390
                Affiliations
                [1 ]Department of Computer Science, Al- Quds University, Jerusalem, Palestinian Territory
                [2 ]Dpertment of Computer Engineering, Istinye University, Istanbul, 34010, Turkey
                [3 ]Department of Faculty of Medicine, Al- Quds University, Jerusalem, Palestinian Territory
                [4 ]Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestinian Territory
                [5 ]Faculty of Public Health, Lebanese University, Beirut, Lebanon
                [6 ]PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
                [7 ]Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
                [8 ]Clinical Research Institute, American University of Beirut, Bliss Street, Riad El Solh 1107 2020, Beirut, Lebanon
                [9 ]Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
                [10 ]Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain
                [11 ]Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Medna, Saudi Arabia
                [12 ]National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
                [13 ]Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
                [14 ]Faculty of Medicine, University of Jordan, Amman, Jordan
                [15 ]Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
                [16 ]Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, 11942, Jordan
                [1 ]Birzeit University, Birzeit, Palestinian Territory
                [1 ]IVF Department, Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Author information
                https://orcid.org/0000-0001-8671-7026
                https://orcid.org/0000-0001-7392-4835
                https://orcid.org/0000-0001-8139-9321
                https://orcid.org/0000-0001-9123-6753
                https://orcid.org/0000-0002-1644-8761
                https://orcid.org/0000-0001-7357-5823
                https://orcid.org/0000-0003-1640-0511
                Article
                10.12688/f1000research.110090.1
                9445566
                36111217
                3790528a-82eb-47f2-93df-9682451855cc
                Copyright: © 2022 Qasrawi R et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 March 2022
                Funding
                The author(s) declared that no grants were involved in supporting this work.
                Categories
                Research Article
                Articles

                machine learning,anxiety,depression,pregnancy,covid-19,random forest

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