Prenatal Stress Detection from Electrocardiography Using Self-Supervised Deep Learning: Development and External Validation

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Autori principali: Frasch, Martin G., Mayer, Marlene J. E., Becker, Clara, Zimmermann, Peter, Zelgert, Camilla, Antonelli, Marta C., Lobmaier, Silvia M.
Natura: Preprint
Pubblicazione: 2026
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author Frasch, Martin G.
Mayer, Marlene J. E.
Becker, Clara
Zimmermann, Peter
Zelgert, Camilla
Antonelli, Marta C.
Lobmaier, Silvia M.
author_facet Frasch, Martin G.
Mayer, Marlene J. E.
Becker, Clara
Zimmermann, Peter
Zelgert, Camilla
Antonelli, Marta C.
Lobmaier, Silvia M.
contents Prenatal psychological stress affects 15-25% of pregnancies and increases risks of preterm birth, low birth weight, and adverse neurodevelopmental outcomes. Current screening relies on subjective questionnaires (PSS-10), limiting continuous monitoring. We developed deep learning models for stress detection from electrocardiography (ECG) using the FELICITy 1 cohort (151 pregnant women, 32-38 weeks gestation). A ResNet-34 encoder was pretrained via SimCLR contrastive learning on 40,692 ECG segments per subject. Multi-layer feature extraction enabled binary classification and continuous PSS prediction across maternal (mECG), fetal (fECG), and abdominal ECG (aECG). External validation used the FELICITy 2 RCT (28 subjects, different ECG device, yoga intervention vs. control). On FELICITy 1 (5-fold CV): mECG 98.6% accuracy (R2=0.88, MAE=1.90), fECG 99.8% (R2=0.95, MAE=1.19), aECG 95.5% (R2=0.75, MAE=2.80). External validation on FELICITy 2: mECG 77.3% accuracy (R2=0.62, MAE=3.54, AUC=0.826), aECG 63.6% (R2=0.29, AUC=0.705). Signal quality-based channel selection outperformed all-channel averaging (+12% R2 improvement). Mixed-effects models detected a significant intervention response (p=0.041). Self-supervised deep learning on pregnancy ECG enables accurate, objective stress assessment, with multi-layer feature extraction substantially outperforming single embedding approaches.
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id arxiv_https___arxiv_org_abs_2602_03886
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Prenatal Stress Detection from Electrocardiography Using Self-Supervised Deep Learning: Development and External Validation
Frasch, Martin G.
Mayer, Marlene J. E.
Becker, Clara
Zimmermann, Peter
Zelgert, Camilla
Antonelli, Marta C.
Lobmaier, Silvia M.
Quantitative Methods
Machine Learning
Prenatal psychological stress affects 15-25% of pregnancies and increases risks of preterm birth, low birth weight, and adverse neurodevelopmental outcomes. Current screening relies on subjective questionnaires (PSS-10), limiting continuous monitoring. We developed deep learning models for stress detection from electrocardiography (ECG) using the FELICITy 1 cohort (151 pregnant women, 32-38 weeks gestation). A ResNet-34 encoder was pretrained via SimCLR contrastive learning on 40,692 ECG segments per subject. Multi-layer feature extraction enabled binary classification and continuous PSS prediction across maternal (mECG), fetal (fECG), and abdominal ECG (aECG). External validation used the FELICITy 2 RCT (28 subjects, different ECG device, yoga intervention vs. control). On FELICITy 1 (5-fold CV): mECG 98.6% accuracy (R2=0.88, MAE=1.90), fECG 99.8% (R2=0.95, MAE=1.19), aECG 95.5% (R2=0.75, MAE=2.80). External validation on FELICITy 2: mECG 77.3% accuracy (R2=0.62, MAE=3.54, AUC=0.826), aECG 63.6% (R2=0.29, AUC=0.705). Signal quality-based channel selection outperformed all-channel averaging (+12% R2 improvement). Mixed-effects models detected a significant intervention response (p=0.041). Self-supervised deep learning on pregnancy ECG enables accurate, objective stress assessment, with multi-layer feature extraction substantially outperforming single embedding approaches.
title Prenatal Stress Detection from Electrocardiography Using Self-Supervised Deep Learning: Development and External Validation
topic Quantitative Methods
Machine Learning
url https://arxiv.org/abs/2602.03886