Postpartum depression risk prediction using explainable machine learning algorithms

ObjectivePostpartum depression (PPD) is a common and serious mental health complication after childbirth, with potential negative consequences for both the mother and her infant. This study aimed to develop an explainable machine learning model to predict the risk of PPD and to identify its key pred...

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Main Authors: Xudong Huang, Lifeng Zhang, Chenyang Zhang, Jing Li, Chenyang Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1565374/full
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author Xudong Huang
Lifeng Zhang
Chenyang Zhang
Jing Li
Chenyang Li
author_facet Xudong Huang
Lifeng Zhang
Chenyang Zhang
Jing Li
Chenyang Li
author_sort Xudong Huang
collection DOAJ
description ObjectivePostpartum depression (PPD) is a common and serious mental health complication after childbirth, with potential negative consequences for both the mother and her infant. This study aimed to develop an explainable machine learning model to predict the risk of PPD and to identify its key predictive factors.MethodsA retrospective analysis was conducted on 1,065 women who attended their 6-week postpartum follow-up visit at a tertiary maternal and child healthcare hospital in Shenyang, China, from January to December 2021. Feature selection was performed using LASSO regression and the Boruta algorithm. Eight machine learning algorithms were then employed to construct the prediction models. Model performance was evaluated according to the area under the receiver operator characteristic curve (AUC), sensitivity, specificity, recall, F1 score, and accuracy. Shapley additive explanations (SHAP) were used to visualize the features of the model and individual case predictions.ResultsAmong the 1,065 women, 251 (23.5%) developed PPD. An 11-variable prediction model was developed, with XGBoost showing the best performance on both training and validation sets. After optimizing the model parameters and applying 10-fold cross-validation, the model achieved an average accuracy of 0.95, an average AUC of 0.955, average precision of 0.945, and average specificity of 0.985, indicating excellent predictive performance. The key predictive factors included weight gain during pregnancy, relationship with the mother-in-law, sleep quality, marital relationship, planned pregnancy, fetal sex preference, pregnancy-related anxiety, pelvic-floor muscle endurance, cervix status, attendance at prenatal education classes, and postpartum care satisfaction.ConclusionThe XGBoost model demonstrated optimal performance at predicting PPD and can aid healthcare professionals to identify high-risk individuals. The SHAP method enhanced the model’s interpretability, facilitating a better understanding of the causes of PPD, how to prevent it, and how to improve patient outcomes.
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spelling doaj-art-fa63b702c582453e8f1a35a20e879d0c2025-08-20T04:00:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.15653741565374Postpartum depression risk prediction using explainable machine learning algorithmsXudong Huang0Lifeng Zhang1Chenyang Zhang2Jing Li3Chenyang Li4Department of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, ChinaDepartment of Maternal, Child and Adolescent Health, School of Public Health, Shenyang Medical College, Shenyang, ChinaDepartment of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, ChinaDepartment of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, ChinaDepartment of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, ChinaObjectivePostpartum depression (PPD) is a common and serious mental health complication after childbirth, with potential negative consequences for both the mother and her infant. This study aimed to develop an explainable machine learning model to predict the risk of PPD and to identify its key predictive factors.MethodsA retrospective analysis was conducted on 1,065 women who attended their 6-week postpartum follow-up visit at a tertiary maternal and child healthcare hospital in Shenyang, China, from January to December 2021. Feature selection was performed using LASSO regression and the Boruta algorithm. Eight machine learning algorithms were then employed to construct the prediction models. Model performance was evaluated according to the area under the receiver operator characteristic curve (AUC), sensitivity, specificity, recall, F1 score, and accuracy. Shapley additive explanations (SHAP) were used to visualize the features of the model and individual case predictions.ResultsAmong the 1,065 women, 251 (23.5%) developed PPD. An 11-variable prediction model was developed, with XGBoost showing the best performance on both training and validation sets. After optimizing the model parameters and applying 10-fold cross-validation, the model achieved an average accuracy of 0.95, an average AUC of 0.955, average precision of 0.945, and average specificity of 0.985, indicating excellent predictive performance. The key predictive factors included weight gain during pregnancy, relationship with the mother-in-law, sleep quality, marital relationship, planned pregnancy, fetal sex preference, pregnancy-related anxiety, pelvic-floor muscle endurance, cervix status, attendance at prenatal education classes, and postpartum care satisfaction.ConclusionThe XGBoost model demonstrated optimal performance at predicting PPD and can aid healthcare professionals to identify high-risk individuals. The SHAP method enhanced the model’s interpretability, facilitating a better understanding of the causes of PPD, how to prevent it, and how to improve patient outcomes.https://www.frontiersin.org/articles/10.3389/fmed.2025.1565374/fullpostpartum depressionmachine learningpredictive modelinfluencing factorsmaternal health
spellingShingle Xudong Huang
Lifeng Zhang
Chenyang Zhang
Jing Li
Chenyang Li
Postpartum depression risk prediction using explainable machine learning algorithms
Frontiers in Medicine
postpartum depression
machine learning
predictive model
influencing factors
maternal health
title Postpartum depression risk prediction using explainable machine learning algorithms
title_full Postpartum depression risk prediction using explainable machine learning algorithms
title_fullStr Postpartum depression risk prediction using explainable machine learning algorithms
title_full_unstemmed Postpartum depression risk prediction using explainable machine learning algorithms
title_short Postpartum depression risk prediction using explainable machine learning algorithms
title_sort postpartum depression risk prediction using explainable machine learning algorithms
topic postpartum depression
machine learning
predictive model
influencing factors
maternal health
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1565374/full
work_keys_str_mv AT xudonghuang postpartumdepressionriskpredictionusingexplainablemachinelearningalgorithms
AT lifengzhang postpartumdepressionriskpredictionusingexplainablemachinelearningalgorithms
AT chenyangzhang postpartumdepressionriskpredictionusingexplainablemachinelearningalgorithms
AT jingli postpartumdepressionriskpredictionusingexplainablemachinelearningalgorithms
AT chenyangli postpartumdepressionriskpredictionusingexplainablemachinelearningalgorithms