Using computerised adaptive tests to screen for perinatal depression in underserved women of colour

Wenzel, Elizabeth M.; Bernabé, Beatriz Peñalver; Dowty, Shannon; Nagelli, Unnathi; Pezley, Lacey; Gibbons, Robert D.; Maki, Pauline M.

doi:10.1136/ebmental-2021-300262

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…This work is a secondary data analysis of a longitudinal cohort study (MoMent) in which participants were recruited from the outpatient obstetrics clinics at a public university hospital, the University of Illinois Chicago (Chicago, IL, USA), from 2018 to 2020 (38). This study was approved by the University of Illinois Chicago Institutional Review Board (IRB #2014-0325).…”

Section: Methodsmentioning

confidence: 99%

Inflammatory dietary potential is associated with vitamin depletion and gut microbial dysbiosis in early pregnancy

Alvernaz,

Wenzel,

Nagelli

et al. 2023

Preprint

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BackgroundPregnancy alters many physiological systems, including the maternal gut microbiota. Diet is a key regulator of this system and can alter host inflammation. Multiple perinatal disorders have been associated with inflammation, maternal metabolic alterations, and gut microbiota dysbiosis, including gestational diabetes mellitus, preeclampsia, preterm birth, and mood disorders. However, the effects of high inflammatory diets on the gut microbiota during pregnancy has yet to be fully explored.ObjectiveTo use a systems-based approach to characterize associations among dietary inflammatory potential, a measure of diet quality, and the gut microbiome during pregnancy.MethodsForty-nine pregnant persons were recruited prior to 16 weeks of gestation. Participants completed a food frequency questionnaire (FFQ) and provided fecal samples. Dietary inflammatory potential was assessed using the Dietary Inflammatory Index (DII) from FFQ data. Fecal samples were analyzed using 16S rRNA amplicon sequencing. Differential taxa abundance with respect to DII score were identified, and microbial metabolic potential was predicted using PICRUSt2.ResultsInflammatory diets were associated with decreased vitamin and mineral intake and dysbiotic gut microbiome structure and metabolism. Gut microbial compositional differences revealed a decrease in short chain fatty acid producers such as g_Faecalibacterium,upregulation of vitamin B12 synthesis, methylglyoxal detoxification, galactose metabolism and multi drug efflux systems in pregnant individuals with increased DII scores.ConclusionsDietary inflammatory potential was associated with depletion of vitamins & minerals and gut microbiota metabolic dysregulation.

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Section: Methodsmentioning

confidence: 99%

Inflammatory dietary potential is associated with vitamin depletion and gut microbial dysbiosis in early pregnancy

Alvernaz,

Wenzel,

Nagelli

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…This work is a secondary data analysis of a longitudinal cohort study (MoMent) in which participants were recruited from the outpatient obstetric clinics at a public university hospital, the University of Illinois Chicago (Chicago, IL, USA), from 2017 to 2020 [38]. This study was approved by the University of Illinois Chicago Institutional Review Board (IRB #2014-0325, 4 September 2014).…”

Section: Participant Recruitmentmentioning

confidence: 99%

Inflammatory Dietary Potential Is Associated with Vitamin Depletion and Gut Microbial Dysbiosis in Early Pregnancy

Alvernaz,

Wenzel,

Nagelli

et al. 2024

Nutrients

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Pregnancy alters many physiological systems, including the maternal gut microbiota. Diet is a key regulator of this system and can alter the host immune system to promote inflammation. Multiple perinatal disorders have been associated with inflammation, maternal metabolic alterations, and gut microbial dysbiosis, including gestational diabetes mellitus, pre-eclampsia, preterm birth, and mood disorders. However, the effects of high-inflammatory diets on the gut microbiota during pregnancy have yet to be fully explored. We aimed to address this gap using a system-based approach to characterize associations among dietary inflammatory potential, a measure of diet quality, and the gut microbiome during pregnancy. Forty-seven pregnant persons were recruited prior to 16 weeks of gestation. Participants completed a food frequency questionnaire (FFQ) and provided fecal samples. Dietary inflammatory potential was assessed using the Dietary Inflammatory Index (DII) from the FFQ data. Fecal samples were analyzed using 16S rRNA amplicon sequencing. Differential taxon abundances with respect to the DII score were identified, and the microbial metabolic potential was predicted using PICRUSt2. Inflammatory diets were associated with decreased vitamin and mineral intake and a dysbiotic gut microbiota structure and predicted metabolism. Gut microbial compositional differences revealed a decrease in short-chain fatty acid producers such as Faecalibacterium, and an increase in predicted vitamin B12 synthesis, methylglyoxal detoxification, galactose metabolism, and multidrug efflux systems in pregnant individuals with increased DII scores. Dietary inflammatory potential was associated with a reduction in the consumption of vitamins and minerals and predicted gut microbiota metabolic dysregulation.

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“…In our own longitudinal studies in low-income women of color, the rate of PND is 23%, while the U.S. average rate is 12%. During the COVID-19 pandemic, the prevalence of PND has risen to 27%-32% (9)(10)(11), highlighting the importance of environmental stressors in these mood disorders (12). PND confers significant obstetric risks of low birth weight (13), preterm labor (13,14), higher maternal morbidity and mortality, longer hospital stays post-delivery and higher delivery costs (15), lower initiation and duration of breastfeeding (16), and poor maternal-fetal attachment (17).…”

Section: Introductionmentioning

confidence: 99%

Predicting prenatal depression and assessing model bias using machine learning models

Huang,

Alvernaz,

Kim

et al. 2023

Preprint

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Perinatal depression (PND) is one of the most common medical complications during pregnancy and postpartum period, affecting 10-20% of pregnant individuals. Black and Latina women have higher rates of PND, yet they are less likely to be diagnosed and receive treatment. Machine learning (ML) models based on Electronic Medical Records (EMRs) have been effective in predicting postpartum depression in middle-class White women but have rarely included sufficient proportions of racial and ethnic minorities, which contributed to biases in ML models for minority women. Our goal is to determine whether ML models could serve to predict depression in early pregnancy in racial/ethnic minority women by leveraging EMR data. We extracted EMRs from a hospital in a large urban city that mostly served low-income Black and Hispanic women (N=5,875) in the U.S. Depressive symptom severity was assessed from a self-reported questionnaire, PHQ-9. We investigated multiple ML classifiers, used Shapley Additive Explanations (SHAP) for model interpretation, and determined model prediction bias with two metrics, Disparate Impact, and Equal Opportunity Difference. While ML model (Elastic Net) performance was low (ROCAUC=0.67), we identified well-known factors associated with PND, such as unplanned pregnancy and being single, as well as underexplored factors, such as self-report pain levels, lower levels of prenatal vitamin supplement intake, asthma, carrying a male fetus, and lower platelet levels blood. Our findings showed that despite being based on a sample mostly composed of 75% low-income minority women (54% Black and 27% Latina), the model performance was lower for these communities. In conclusion, ML models based on EMRs could moderately predict depression

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Using computerised adaptive tests to screen for perinatal depression in underserved women of colour

Cited by 5 publications

References 24 publications

Inflammatory dietary potential is associated with vitamin depletion and gut microbial dysbiosis in early pregnancy

Inflammatory dietary potential is associated with vitamin depletion and gut microbial dysbiosis in early pregnancy

Inflammatory Dietary Potential Is Associated with Vitamin Depletion and Gut Microbial Dysbiosis in Early Pregnancy

Predicting prenatal depression and assessing model bias using machine learning models

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