论文标题
从心电图中检测产妇和胎儿应力,并以自我监督的表示
Detection of Maternal and Fetal Stress from the Electrocardiogram with Self-Supervised Representation Learning
论文作者
论文摘要
在怀孕的母亲和她的胎儿中,慢性产前应激导致母体心跳夹带胎儿心跳,并由胎儿应激指数(FSI)量化。在嘈杂的现实生活环境中,深度学习(DL)能够在复杂的医学数据中具有高度准确性的模式检测,但是对于怀孕期间的非侵入性生物识别监测的DL效用知之甚少。最近建立的自我监督学习(SSL)DL方法提供了心电图(ECG)的情感识别。我们假设SSL将发现来自原始母体腹部心电图(AECG)的长期压力的母亲偏见,其中包含胎儿和母体ECG。研究了在妊娠32周时在入学时持续压力的母亲和对照组。我们通过心理库存,母体皮质醇和FSI验证了慢性压力暴露。我们测试了SSL体系结构的两种变体,其中一种对来自公共数据集获得的情感识别的通用ECG功能进行了培训,另一个在我们的数据子集中进行了转移。我们的DL模型准确地检测了慢性应激暴露组(AUROC = 0.982 +/- 0.002),妊娠34周的个人心理压力评分(R2 = 0.943 +/- 0.009)和FSI(R2 = 0.946 +/- 0.013),以及在出生反射式的Chrsonic+/0.93时(r2 = 0.946 +/- 0.013),以及0.93。通过在公共数据集中训练并仅使用母体心电图的DL模型实现了最佳性能。当前的DL方法为暴露于慢性压力的不同调节系统之间的复杂多模式关系提供了一种新颖的生理见解来源。最终的DL模型可以在怀孕期间简单,无处不在的早期压力检测和监测工具中部署在低成本的常规ECG生物传感器中。这一发现应实现早期行为干预措施。
In the pregnant mother and her fetus, chronic prenatal stress results in entrainment of the fetal heartbeat by the maternal heartbeat, quantified by the fetal stress index (FSI). Deep learning (DL) is capable of pattern detection in complex medical data with high accuracy in noisy real-life environments, but little is known about DL's utility in non-invasive biometric monitoring during pregnancy. A recently established self-supervised learning (SSL) approach to DL provides emotional recognition from electrocardiogram (ECG). We hypothesized that SSL will identify chronically stressed mother-fetus dyads from the raw maternal abdominal electrocardiograms (aECG), containing fetal and maternal ECG. Chronically stressed mothers and controls matched at enrolment at 32 weeks of gestation were studied. We validated the chronic stress exposure by psychological inventory, maternal hair cortisol and FSI. We tested two variants of SSL architecture, one trained on the generic ECG features for emotional recognition obtained from public datasets and another transfer-learned on a subset of our data. Our DL models accurately detect the chronic stress exposure group (AUROC=0.982+/-0.002), the individual psychological stress score (R2=0.943+/-0.009) and FSI at 34 weeks of gestation (R2=0.946+/-0.013), as well as the maternal hair cortisol at birth reflecting chronic stress exposure (0.931+/-0.006). The best performance was achieved with the DL model trained on the public dataset and using maternal ECG alone. The present DL approach provides a novel source of physiological insights into complex multi-modal relationships between different regulatory systems exposed to chronic stress. The final DL model can be deployed in low-cost regular ECG biosensors as a simple, ubiquitous early stress detection and monitoring tool during pregnancy. This discovery should enable early behavioral interventions.