Date of Award

August 2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Computer Science

First Advisor

Susan McRoy

Committee Members

Jake Luo, Teresa Johnson, Yetunde Folajimi, Anna Palatnik

Keywords

Biomedical and Health Informatics, Concurrence, Deep Learning, Gestational Diabetes Mellitus, Hypertensive Disorders of Pregnancy, Machine Learning

Abstract

Gestational diabetes mellitus and hypertensive disorders in pregnancy are serious maternal health conditions with immediate and lifelong mother-child health consequences. These obstetric pathologies have been widely investigated, but mostly in silos, while studies focusing on their simultaneous occurrence rarely exist. This is especially the case in the machine learning domain. This retrospective study sought to investigate, construct, evaluate, compare, and isolate a supervised machine learning predictive model for the binary classification of co-occurring gestational diabetes mellitus and hypertensive disorders in pregnancy in a cohort of otherwise healthy pregnant women. To accomplish the stated aims, this study analyzed an extract (n=4624, n_features=38) of a labelled maternal perinatal dataset (n=9967, n_fields=79) collected by the PeriData.Net® database from a participating community hospital in Southeast Wisconsin between 2013 and 2018. The datasets were named, “WiseSample” and “WiseSubset” respectively in this study. Thirty-three models were constructed with the six supervised machine learning algorithms explored on the extracted dataset: logistic regression, random forest, decision tree, support vector machine, StackingClassifier, and KerasClassifier, which is a deep learning classification algorithm; all were evaluated using the StratifiedKfold cross-validation (k=10) method. The Synthetic Minority Oversampling Technique was applied to the training data to resolve the class imbalance that was noted in the sub-sample at the preprocessing phase. A wide range of evidence-based feature selection techniques were used to identify the best predictors of the comorbidity under investigation. Multiple model performance evaluation metrics that were employed to quantitatively evaluate and compare model performance quality include accuracy, F1, precision, recall, and the area under the receiver operating characteristic curve. Support Vector Machine objectively emerged as the most generalizable model for identifying the gravidae in WiseSubset who may develop concurrent gestational diabetes mellitus and hypertensive disorders in pregnancy, scoring 100.00% (mean) in recall. The model consisted of 9 predictors extracted by the recursive feature elimination with cross-validation with random forest. Finding from this study show that appropriate machine learning methods can reliably predict comorbid gestational diabetes and hypertensive disorders in pregnancy, using readily available routine prenatal attributes. Six of the nine most predictive factors of the comorbidity were also in the top 6 selections of at least one other feature selection method examined. The six predictors are healthy weight prepregnancy BMI, mother’s educational status, husband’s educational status, husband’s occupation in one year before the current pregnancy, mother’s blood group, and mother’s age range between 34 and 44 years. Insight from this analysis would support clinical decision making of obstetric experts when they are caring for 1.) nulliparous women, since they would have no obstetric history that could prompt their care providers for feto-maternal medical surveillance; and 2.) the experienced mothers with no obstetric history suggestive of any of the disease(s) under this study. Hence, among other benefits, the artificial-intelligence-backed tool designed in this research would likely improve maternal and child care quality outcomes.

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