{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:36:42Z","timestamp":1791221802781,"version":"4.1.0"},"reference-count":55,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Inform"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postpartum depression (PPD) is a prevalent mental health issue with significant impacts on mothers and families. Exploring reliable predictors is crucial for the early and accurate prediction of PPD, which remains challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to comprehensively collect variables from multiple aspects, develop and validate machine learning models to achieve precise prediction of PPD, and interpret the model to reveal clinical implications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study recruited pregnant women who delivered at the West China Second University Hospital, Sichuan University. Various variables were collected from electronic medical record data and screened using least absolute shrinkage and selection operator penalty regression. Participants were divided into training (1358\/2055, 66.1%) and validation (697\/2055, 33.9%) sets by random sampling. Machine learning\u2013based predictive models were developed in the training cohort. Models were validated in the validation cohort with receiver operating curve and decision curve analysis. Multiple model interpretation methods were implemented to explain the optimal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recruited 2055 participants in this study. The extreme gradient boosting model was the optimal predictive model with the area under the receiver operating curve of 0.849. Shapley Additive Explanation indicated that the most influential predictors of PPD were antepartum depression, lower fetal weight, elevated thyroid-stimulating hormone, declined thyroid peroxidase antibodies, elevated serum ferritin, and older age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study developed and validated a machine learning\u2013based predictive model for PPD. Several significant risk factors and how they impact the prediction of PPD were revealed. These findings provide new insights into the early screening of individuals with high risk for PPD, emphasizing the need for comprehensive screening approaches that include both physiological and psychological factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/58649","type":"journal-article","created":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T21:22:16Z","timestamp":1737926536000},"page":"e58649-e58649","source":"Crossref","is-referenced-by-count":33,"title":["Interpretable Machine Learning Model for Predicting Postpartum Depression: Retrospective Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9469-384X","authenticated-orcid":false,"given":"Ren","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-0021","authenticated-orcid":false,"given":"Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2146-3901","authenticated-orcid":false,"given":"Zhiwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0048-4531","authenticated-orcid":false,"given":"Rui","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8301-638X","authenticated-orcid":false,"given":"Bin","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"issue":"22","key":"R1","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1056\/NEJMcp1607649","article-title":"Postpartum depression","volume":"375","author":"Stewart","journal-title":"N Engl J Med"},{"issue":"9956","key":"R2","doi-asserted-by":"publisher","first-page":"1775","DOI":"10.1016\/S0140-6736(14)61276-9","article-title":"Non-psychotic mental disorders in the perinatal period","volume":"384","author":"Howard","journal-title":"Lancet"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2017.00248","article-title":"Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries","volume":"8","author":"Hahn-Holbrook","journal-title":"Front Psychiatry"},{"key":"R4","volume":"182","author":"Cooper","journal-title":"Br J Psychiatry"},{"issue":"10","key":"R5","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/S2215-0366(16)30284-X","article-title":"Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries","volume":"3","author":"Gelaye","journal-title":"Lancet Psychiatry"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050212-185612","article-title":"Postpartum depression: current status and future directions","volume":"9","author":"O\u2019Hara","journal-title":"Annu Rev Clin Psychol"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1001\/jama.2019.0007","article-title":"Interventions to prevent perinatal depression: US Preventive Services Task Force recommendation statement","volume":"321","author":"US Preventive Services Task Force","journal-title":"JAMA"},{"issue":"9","key":"R8","doi-asserted-by":"publisher","first-page":"1780","DOI":"10.1007\/s10995-016-1989-x","article-title":"Racial\/ethnic disparities in antenatal depression in the United States: a systematic review","volume":"20","author":"Mukherjee","journal-title":"Matern Child Health J"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/j.1523-536X.2006.00130.x","article-title":"Postpartum depression help\u2010seeking barriers and maternal treatment preferences: a qualitative systematic review","volume":"33","author":"Dennis","journal-title":"Birth"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1001\/jama.2018.20865","article-title":"Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force","volume":"321","author":"O\u2019Connor","journal-title":"JAMA"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.contraception.2008.09.009","article-title":"Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors","volume":"79","author":"Cheng","journal-title":"Contraception"},{"issue":"5","key":"R12","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1089\/jwh.2014.4857","article-title":"Stressful events during pregnancy and postpartum depressive symptoms","volume":"24","author":"Stone","journal-title":"J Womens Health (Larchmt)"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jclinepi.2012.11.008","article-title":"Using methods from the data-mining and machine-learning literature for disease classification and prediction: a case study examining classification of heart failure subtypes","volume":"66","author":"Austin","journal-title":"J Clin Epidemiol"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2023.08.002","article-title":"Machine learning models of plasma proteomic data predict mood in chronic stroke and tie it to aberrant peripheral immune responses","volume":"114","author":"Bidoki","journal-title":"Brain Behav Immun"},{"issue":"9","key":"R15","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9092899","article-title":"Machine learning-based predictive modeling of postpartum depression","volume":"9","author":"Shin","journal-title":"J Clin Med"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/da.23123","article-title":"Development and validation of a machine learning-based postpartum depression prediction model: a nationwide cohort study","volume":"38","author":"Hochman","journal-title":"Depress Anxiety"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04087-8","article-title":"Estimation of postpartum depression risk from electronic health records using machine learning","volume":"21","author":"Amit","journal-title":"BMC Pregnancy Childbirth"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox","journal-title":"Br J Psychiatry"},{"key":"R19","doi-asserted-by":"crossref","unstructured":"Diagnostic and Statistical Manual of Mental Disorders. 5thed. American Psychiatric Association; 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"R20","unstructured":"The Chinese Classification and Diagnostic Criteria of Mental Disorders. 3rded. Chinese Society of Psychiatry; 2001:184-188."},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1965.01720310065008","article-title":"A self-rating depression scale","volume":"12","author":"Zung","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1080\/13548506.2020.1746817","article-title":"Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China","volume":"26","author":"Wang","journal-title":"Psychol Health Med"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6874-14-67","article-title":"Health-related quality of life and influencing factors among rural left-behind wives in Liuyang, China","volume":"14","author":"Yi","journal-title":"BMC Womens Health"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.05.003","article-title":"Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China","volume":"253","author":"Tang","journal-title":"J Affect Disord"},{"issue":"2","key":"R25","first-page":"303","volume":"15","author":"Smilkstein","journal-title":"J Fam Pract"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1111\/j.2517-6161.1996.tb02080.x","article-title":"Regression shrinkage and selection via the lasso","volume":"58","author":"Tibshirani","journal-title":"J R Stat Soc Ser B"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1214\/009053604000000067","article-title":"Least angle regression","volume":"32","author":"Efron","journal-title":"Ann Statist"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1214\/08-AOS620","article-title":"Simultaneous analysis of lasso and Dantzig selector","volume":"37","author":"Bickel","journal-title":"Ann Statist"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1177\/002224379102800302","article-title":"Collinearity, power, and interpretation of multiple regression analysis","volume":"28","author":"Mason","journal-title":"J Market Res"},{"issue":"12","key":"R30","doi-asserted-by":"publisher","first-page":"4093","DOI":"10.1007\/s00204-024-03852-w","article-title":"Predictive biomarkers for embryotoxicity: a machine learning approach to mitigating multicollinearity in RNA-Seq","volume":"98","author":"Quah","journal-title":"Arch Toxicol"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1177\/15910199241267320","article-title":"Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms\u2014a retrospective analysis of the WorldWide WEB Consortium database","author":"Musmar","journal-title":"Interv Neuroradiol"},{"issue":"5","key":"R32","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/s11135-006-9018-6","article-title":"A caution regarding rules of thumb for variance inflation factors","volume":"41","author":"O\u2019brien","journal-title":"Qual Quant"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-023-04572-w","article-title":"Reliability and validity of the Turkish version of the New Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire","volume":"39","author":"Ozata","journal-title":"Int J Colorectal Dis"},{"key":"R34","doi-asserted-by":"crossref","unstructured":"Chen TQ Guestrin C Comp MA . XGBoost: a scalable tree boosting system. Presented at: 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining (KDD); Aug 13-17, 2016; San Francisco, CA, United States.","DOI":"10.1145\/2939672.2939785"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","journal-title":"Mach Learn"},{"issue":"5","key":"R36","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1214\/aos\/1013203451","article-title":"Greedy function approximation: a gradient boosting machine","volume":"29","author":"Friedman","journal-title":"Ann Statist"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-12394-0","article-title":"Linking synthesis and structure descriptors from a large collection of synthetic records of zeolite materials","volume":"10","author":"Muraoka","journal-title":"Nat Commun"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3348\/kjr.2004.5.1.11","article-title":"Receiver operating characteristic (ROC) curve: practical review for radiologists","volume":"5","author":"Park","journal-title":"Korean J Radiol"},{"issue":"3","key":"R39","doi-asserted-by":"publisher","first-page":"e158","DOI":"10.1016\/S2589-7500(20)30314-9","article-title":"Application of a novel machine learning framework for predicting non-metastatic prostate cancer-specific mortality in men using the Surveillance, Epidemiology, and End Results (SEER) database","volume":"3","author":"Lee","journal-title":"Lancet Digit Health"},{"key":"R40","volume":"20","author":"Fisher","journal-title":"J Mach Learn Res"},{"issue":"1","key":"R41","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1080\/10618600.2014.907095","article-title":"Peeking inside the black box: visualizing statistical learning with plots of individual conditional expectation","volume":"24","author":"Goldstein","journal-title":"J Comput Graph Stat"},{"key":"R42","unstructured":"Lundberg SM Lee SI . A unified approach to interpreting model predictions. Presented at: 31st Annual Conference on Neural Information Processing Systems (NIPS); Dec 4-9, 2017; Long Beach, CA, United States."},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.09.099","article-title":"The development and application of a prediction model for postpartum depression: optimizing risk assessment and prevention in the clinic","volume":"296","author":"Yang","journal-title":"J Affect Disord"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-14693-3","article-title":"Maturation of the human striatal dopamine system revealed by PET and quantitative MRI","volume":"11","author":"Larsen","journal-title":"Nat Commun"},{"issue":"11","key":"R45","doi-asserted-by":"publisher","first-page":"2742","DOI":"10.1038\/s41380-020-0685-9","article-title":"Prefrontal cortex circuits in depression and anxiety: contribution of discrete neuronal populations and target regions","volume":"25","author":"Hare","journal-title":"Mol Psychiatry"},{"issue":"10101","key":"R46","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1016\/S0140-6736(17)30703-1","article-title":"Hypothyroidism","volume":"390","author":"Chaker","journal-title":"Lancet"},{"issue":"10","key":"R47","doi-asserted-by":"publisher","first-page":"102649","DOI":"10.1016\/j.autrev.2020.102649","article-title":"Hashimoto\u2019s thyroiditis: an update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation","volume":"19","author":"Ralli","journal-title":"Autoimmun Rev"},{"issue":"10047","key":"R48","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1016\/S0140-6736(16)00278-6","article-title":"Hyperthyroidism","volume":"388","author":"De Leo","journal-title":"Lancet"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2020.102353","article-title":"Risk factors for postpartum depression: an evidence-based systematic review of systematic reviews and meta-analyses","volume":"53","author":"Zhao","journal-title":"Asian J Psychiatr"},{"issue":"5","key":"R50","doi-asserted-by":"publisher","first-page":"661","DOI":"10.5498\/wjp.v14.i5.661","article-title":"Clinical risk factors for preterm birth and evaluating maternal psychology in the postpartum period","volume":"14","author":"Chen","journal-title":"World J Psychiatry"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02909-9","article-title":"Investigating heart rate variability measures during pregnancy as predictors of postpartum depression and anxiety: an exploratory study","volume":"14","author":"Eriksson","journal-title":"Transl Psychiatry"},{"issue":"7","key":"R52","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e27843","article-title":"Health related quality of life and its predictors among postpartum mother in Southeast Ethiopia: a cross-sectional study","volume":"10","author":"Gomora","journal-title":"Heliyon"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-54927-8","article-title":"Prevalence and risk factors analysis of postpartum depression at early stage using hybrid deep learning model","volume":"14","author":"Lilhore","journal-title":"Sci Rep"},{"issue":"8","key":"R54","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1017\/S0033291723003707","article-title":"Within-individual relationships between mother-to-infant bonding and postpartum depressive symptoms: a longitudinal study","volume":"54","author":"Hiraoka","journal-title":"Psychol Med"},{"issue":"16","key":"R55","doi-asserted-by":"publisher","first-page":"7953","DOI":"10.1017\/S0033291723002118","article-title":"The trajectory of maternal perinatal depressive symptoms predicts executive function in early childhood","volume":"53","author":"Power","journal-title":"Psychol Med"}],"container-title":["JMIR Medical Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medinform.jmir.org\/2025\/1\/e58649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:50:42Z","timestamp":1782841842000},"score":1,"resource":{"primary":{"URL":"https:\/\/medinform.jmir.org\/2025\/1\/e58649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,20]]},"references-count":55,"URL":"https:\/\/doi.org\/10.2196\/58649","relation":{},"ISSN":["2291-9694"],"issn-type":[{"value":"2291-9694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,20]]},"article-number":"v13i22e58649"}}