Development of early prediction model for pregnancy-associated hypertension with graph-based semi-supervised learning.

Journal: Scientific reports
PMID:

Abstract

Clinical guidelines recommend several risk factors to identify women in early pregnancy at high risk of developing pregnancy-associated hypertension. However, these variables result in low predictive accuracy. Here, we developed a prediction model for pregnancy-associated hypertension using graph-based semi-supervised learning. This is a secondary analysis of a prospective study of healthy pregnant women. To develop the prediction model, we compared the prediction performances across five machine learning methods (semi-supervised learning with both labeled and unlabeled data, semi-supervised learning with labeled data only, logistic regression, support vector machine, and random forest) using three different variable sets: [a] variables from clinical guidelines, [b] selected important variables from the feature selection, and [c] all routine variables. Additionally, the proposed prediction model was compared with placental growth factor, a predictive biomarker for pregnancy-associated hypertension. The study population consisted of 1404 women, including 1347 women with complete follow-up (labeled data) and 57 women with incomplete follow-up (unlabeled data). Among the 1347 with complete follow-up, 2.4% (33/1347) developed pregnancy-associated HTN. Graph-based semi-supervised learning using top 11 variables achieved the best average prediction performance (mean area under the curve (AUC) of 0.89 in training set and 0.81 in test set), with higher sensitivity (72.7% vs 45.5% in test set) and similar specificity (80.0% vs 80.5% in test set) compared to risk factors from clinical guidelines. In addition, our proposed model with graph-based SSL had a higher performance than that of placental growth factor for total study population (AUC, 0.71 vs. 0.80, p < 0.001). In conclusion, we could accurately predict the development pregnancy-associated hypertension in early pregnancy through the use of routine clinical variables with the help of graph-based SSL.

Authors

  • Seung Mi Lee
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Yonghyun Nam
    Department of Industrial Engineering, Ajou University, Wonchun-dong, Yeongtong-gu, Suwon, 443-749, South Korea.
  • Eun Saem Choi
    Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea.
  • Young Mi Jung
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Vivek Sriram
    Department of Biostatistics, Epidemiology and Informatics, The Perelman School of Medicine, University of Pennsylvania, B304 Richards Building, 3700 Hamilton Walk, Philadelphia, PA, 19104-6116, USA.
  • Jacob S Leiby
    Department of Biostatistics, Epidemiology and Informatics, The Perelman School of Medicine, University of Pennsylvania, B304 Richards Building, 3700 Hamilton Walk, Philadelphia, PA, 19104-6116, USA.
  • Ja Nam Koo
    Seoul Women's Hospital, Incheon, South Korea.
  • Ig Hwan Oh
    Seoul Women's Hospital, Incheon, South Korea.
  • Byoung Jae Kim
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Sun Min Kim
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Sang Youn Kim
    Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea.
  • Gyoung Min Kim
    Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.
  • Sae Kyung Joo
    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
  • Sue Shin
    Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.
  • Errol R Norwitz
    Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA.
  • Chan-Wook Park
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Jong Kwan Jun
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
  • Won Kim
    Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
  • Dokyoon Kim
    Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, USA.
  • Joong Shin Park
    Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. jsparkmd@snu.ac.kr.