Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Preprint |
| Published: |
2026
|
| Subjects: | |
| Online Access: | https://arxiv.org/abs/2605.13786 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1866916010258333696 |
|---|---|
| author | Sun, Chuanchuan Yu, Zhen Fan, Qin Chen, Qingchao Yu, Feng |
| author_facet | Sun, Chuanchuan Yu, Zhen Fan, Qin Chen, Qingchao Yu, Feng |
| contents | Background: Pregnancy-associated thrombotic microangiopathy (P-TMA) is rare but life-threatening. Early risk prediction before overt clinical presentation remains challenging, as the associated laboratory abnormalities are subtle, multidimensional, and frequently masked by common physiological changes such as gestational thrombocytopenia and pregnancy-related proteinuria, thus overlapping heavily with benign obstetric and renal conditions. This complexity is poorly captured by univariate or rule-based approaches; however, it is addressable by machine learning, which can extract latent, time-dependent risk signatures from longitudinal clinical tests. Methods: This retrospective study included 300 pregnancies comprising 142 P-TMA cases and 158 controls. After exclusion of identifiers and non-informative variables, 146 longitudinal laboratory predictors were retained. Participants were divided into a training cohort (80%) and a held-out test cohort (20%) using stratified sampling. Five algorithms were evaluated: logistic regression, support vector machine with radial basis function kernel, random forest, extra trees, and gradient boosting. The final model was selected by mean cross-validated AUROC, refitted on the full training cohort, and evaluated once in the held-out test cohort. Interpretability analyses examined global feature importance and distributional patterns of leading predictors. Results: Gradient boosting was prespecified by cross-validation in the training cohort. The model achieved an AUROC of 0.872 (95% CI: 0.769-0.952) and an AUPRC of 0.883 (95% CI: 0.780-0.959) in a held-out test cohort, with sensitivity of 0.750 and specificity of 0.812. Conclusions: Longitudinal clinical laboratory tests obtained during routine care contained informative and clinically plausible signals for P-TMA risk. Notably, cystatin C at week 6 showed promise as an early monitoring indicator. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2605_13786 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Interpretable Machine Learning for Antepartum Prediction of Pregnancy-Associated Thrombotic Microangiopathy Using Routine Longitudinal Laboratory Data Sun, Chuanchuan Yu, Zhen Fan, Qin Chen, Qingchao Yu, Feng Machine Learning Background: Pregnancy-associated thrombotic microangiopathy (P-TMA) is rare but life-threatening. Early risk prediction before overt clinical presentation remains challenging, as the associated laboratory abnormalities are subtle, multidimensional, and frequently masked by common physiological changes such as gestational thrombocytopenia and pregnancy-related proteinuria, thus overlapping heavily with benign obstetric and renal conditions. This complexity is poorly captured by univariate or rule-based approaches; however, it is addressable by machine learning, which can extract latent, time-dependent risk signatures from longitudinal clinical tests. Methods: This retrospective study included 300 pregnancies comprising 142 P-TMA cases and 158 controls. After exclusion of identifiers and non-informative variables, 146 longitudinal laboratory predictors were retained. Participants were divided into a training cohort (80%) and a held-out test cohort (20%) using stratified sampling. Five algorithms were evaluated: logistic regression, support vector machine with radial basis function kernel, random forest, extra trees, and gradient boosting. The final model was selected by mean cross-validated AUROC, refitted on the full training cohort, and evaluated once in the held-out test cohort. Interpretability analyses examined global feature importance and distributional patterns of leading predictors. Results: Gradient boosting was prespecified by cross-validation in the training cohort. The model achieved an AUROC of 0.872 (95% CI: 0.769-0.952) and an AUPRC of 0.883 (95% CI: 0.780-0.959) in a held-out test cohort, with sensitivity of 0.750 and specificity of 0.812. Conclusions: Longitudinal clinical laboratory tests obtained during routine care contained informative and clinically plausible signals for P-TMA risk. Notably, cystatin C at week 6 showed promise as an early monitoring indicator. |
| title | Interpretable Machine Learning for Antepartum Prediction of Pregnancy-Associated Thrombotic Microangiopathy Using Routine Longitudinal Laboratory Data |
| topic | Machine Learning |
| url | https://arxiv.org/abs/2605.13786 |