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Appl Clin Inform 2022; 13(01): 287-300
DOI: 10.1055/s-0042-1743240
DOI: 10.1055/s-0042-1743240
Research Article
Design and Evaluation of a Postpartum Depression Ontology
Funding We thank the University of Pennsylvania for generous funds to support this project (R.B.M., S.P.C., and M.R.B.). Support also provided by the Penn Injury Science Center (B.A.D'A., S.P.C., and M.R.B.) which is an Injury Control Research Center funded by the Centers for Disease Control and Prevention (CDC; grant no.: R49CE003083). Support also provided by the NIH NINDS brain injury training grant (grant no.: T32 NS 043126) supporting A.C.B. with mentors M.R.B. and A.L.C.S.
Abstract
Objective Postpartum depression (PPD) remains an understudied research area despite its high prevalence. The goal of this study is to develop an ontology to aid in the identification of patients with PPD and to enable future analyses with electronic health record (EHR) data.
Methods We used Protégé-OWL to construct a postpartum depression ontology (PDO) of relevant comorbidities, symptoms, treatments, and other items pertinent to the study and treatment of PPD.
Results The PDO identifies and visualizes the risk factor status of variables for PPD, including comorbidities, confounders, symptoms, and treatments. The PDO includes 734 classes, 13 object properties, and 4,844 individuals. We also linked known and potential risk factors to their respective codes in the International Classification of Diseases versions 9 and 10 that would be useful in structured EHR data analyses. The representation and usefulness of the PDO was assessed using a task-based patient case study approach, involving 10 PPD case studies. Final evaluation of the ontology yielded 86.4% coverage of PPD symptoms, treatments, and risk factors. This demonstrates strong coverage of the PDO for the PPD domain.
Conclusion The PDO will enable future researchers to study PPD using EHR data as it contains important information with regard to structured (e.g., billing codes) and unstructured data (e.g., synonyms of symptoms not coded in EHRs). The PDO is publicly available through the National Center for Biomedical Ontology (NCBO) BioPortal ( https://bioportal.bioontology.org/ontologies/PARTUMDO ) which will enable other informaticists to utilize the PDO to study PPD in other populations.
Protection of Human and Animal Subjects
This research did not involve human subjects.
Author Contribution
Conceived study design: R.B.M. and M.R.B. Developed methodology: R.B.M., B.A.D'A., and M.R.B. Provided clinical advice pertinent to study problem: A.L.C.S. and A.C.B. Wrote paper: R.B.M. and M.R.B. Reviewed, edited, and approved final manuscript: R.B.M., A.C.B., B.A.D'A., S.P.C., A.L.C.S., and M.R.B.
Publication History
Received: 20 August 2021
Accepted: 04 January 2022
Article published online:
09 March 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Henshaw C. Mood disturbance in the early puerperium: a review. Arch Women Ment Health 2003; 6 (s2): S33-S42
- 2 Muzik M, Borovska S. Perinatal depression: implications for child mental health. Ment Health Fam Med 2010; 7 (04) 239-247
- 3 O'Hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 1996; 8 (01) 37-54
- 4 Centers for Disease Control and Prevention (CDC). Prevalence of self-reported postpartum depressive symptoms–17 states, 2004-2005. MMWR Morb Mortal Wkly Rep 2008; 57 (14) 361-366
- 5 Depression in pregnant women and mothers: how children are affected. Paediatr Child Health 2004; 9 (08) 584-601
- 6 Stewart DE, Vigod S. Postpartum depression. N Engl J Med 2016; 375 (22) 2177-2186
- 7 Silverman ME, Reichenberg A, Savitz DA. et al. The risk factors for postpartum depression: a population-based study. Depress Anxiety 2017; 34 (02) 178-187
- 8 Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 2004; 26 (04) 289-295
- 9 Johnstone SJ, Boyce PM, Hickey AR, Morris-Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Aust N Z J Psychiatry 2001; 35 (01) 69-74
- 10 Blom EA, Jansen PW, Verhulst FC. et al. Perinatal complications increase the risk of postpartum depression. The generation R study. BJOG 2010; 117 (11) 1390-1398
- 11 Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: a meta-analysis. J Psychosom Res 2017; 97: 118-126
- 12 Miller ES, Peri MR, Gossett DR. The association between diabetes and postpartum depression. Arch Women Ment Health 2016; 19 (01) 183-186
- 13 Zadeh MA, Khajehei M, Sharif F, Hadzic M. High-risk pregnancy: effects on postpartum depression and anxiety. Br J Midwifery 2012; 20 (02) 104-113
- 14 Lee SH, Liu LC, Kuo PC, Lee MS. Postpartum depression and correlated factors in women who received in vitro fertilization treatment. J Midwifery Womens Health 2011; 56 (04) 347-352
- 15 Casey JA, Schwartz BS, Stewart WF, Adler NE. Using electronic health records for population health research: a review of methods and applications. Annu Rev Public Health 2016; 37: 61-81
- 16 Bullock K. The sun will shine again: my postpartum depression story. Accessed April 11, 2021 at: https://www.osfhealthcare.org/blog/the-sun-will-shine-again-my-postpartum-depression-story/
- 17 Varma S. Patient story: postpartum depression. April 11, 2021. Available at: https://www.psychiatry.org/patients-families/postpartum-depression/patient-story
- 18 Taylor M. 5 women share what got them through postpartum depression and anxiety. Accessed April 11, 2021 at: https://www.self.com/story/postpartum-depression-and-anxiety-stories
- 19 Jones C. You are not alone. Sharing our stories of hope and healing. Accessed April 11, 2021 at: https://postpartumny.org/sharingourstories/
- 20 Bannister K. Kelley's story of postpartum depression. Accessed April 11, 2021 at: https://postpartum.org/2014/08/kelleys-story-postpartum-depression/
- 21 Lardner J. Postpartum depression: a survivor's story. Accessed April 11, 2021 at: https://www.stepupformentalhealth.org/postpartum-depression-a-survivors-story/
- 22 Houston C. My battle with postpartum depression. Accessed April 11, 2021 at: https://www.ameda.com/milk-101/milk-101-article/postpartum-depression-survivor-success-story/
- 23 Santiago-Munoz P. Overcoming postpartum depression: Elaine's story. Accessed April 11, 2021 at: https://utswmed.org/medblog/overcoming-postpartum-depression/
- 24 Liberati A, Altman DG, Tetzlaff J. et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6 (07) e1000100
- 25 Beck CT. Predictors of postpartum depression: an update. Nurs Res 2001; 50 (05) 275-285
- 26 Gordon CL, Pouch S, Cowell LG. et al. Design and evaluation of a bacterial clinical infectious diseases ontology. AMIA Annu Symp Proc 2013; 2013: 502-511
- 27 Horng S, Greenbaum NR, Nathanson LA, McClay JC, Goss FR, Nielson JA. Consensus development of a modern ontology of emergency department presenting problems-The Hierarchical Presenting Problem Ontology (HaPPy). Appl Clin Inform 2019; 10 (03) 409-420
- 28 Musen MA. The Protégé project: a look back and a look forward. AI Matters 2015; 1 (14) 4-12
- 29 Stewart DE, Robertson E, Dennis C-L, Grace SL, Wallington T. Postpartum Depression: Literature Review of Risk Factors and Interventions. Accessed January 18, 2022 at: https://www.who.int/mental_health/prevention/suicide/lit_review_postpartum_depression.pdf
- 30 Borland D, Christopherson L, Schmitt C. Ontology-based interactive visualization of patient-generated research questions. Appl Clin Inform 2019; 10 (03) 377-386
- 31 Pope CJ, Mazmanian D. Breastfeeding and postpartum depression: an overview and methodological recommendations for future research. Depress Res Treat 2016; 2016: 4765310
- 32 Documentation P. Class expression syntax. Accessed March 10, 2021 at: http://protegeproject.github.io/protege/class-expression-syntax/
- 33 Scholten AC, Haagsma JA, Cnossen MC, Olff M, van Beeck EF, Polinder S. Prevalence of and risk factors for anxiety and depressive disorders after traumatic brain injury: a systematic review. J Neurotrauma 2016; 33 (22) 1969-1994
- 34 Wiseman T, Foster K, Curtis K. Mental health following traumatic physical injury: an integrative literature review. Injury 2013; 44 (11) 1383-1390
- 35 Kendall-Tackett KA. Violence against women and the perinatal period: the impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma Violence Abuse 2007; 8 (03) 344-353
- 36 Organization WH. Preterm birth. Accessed March 13, 2021 at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
- 37 Guintivano J, Sullivan PF, Stuebe AM. et al. Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women. Psychol Med 2018; 48 (07) 1190-1200
- 38 Kim TH, Connolly JA, Tamim H. The effect of social support around pregnancy on postpartum depression among Canadian teen mothers and adult mothers in the maternity experiences survey. BMC Pregnancy Childbirth 2014; 14: 162
- 39 Rasmussen MH, Strøm M, Wohlfahrt J, Videbech P, Melbye M. Risk, treatment duration, and recurrence risk of postpartum affective disorder in women with no prior psychiatric history: a population-based cohort study. PLoS Med 2017; 14 (09) e1002392
- 40 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-786
- 41 Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1 (03) 385-401
- 42 Beck AT, Steer R, Brown G. Beck Depression Inventory-II. San Antonio, TX: Pearson; 1996
- 43 Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16 (09) 606-613
- 44 Taylor SE, Brown JD. Illusion and well-being: a social psychological perspective on mental health. Psychol Bull 1988; 103 (02) 193-210
- 45 Borra C, Iacovou M, Sevilla A. New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions. Matern Child Health J 2015; 19 (04) 897-907
- 46 Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc 2016; 9: 211-217
- 47 Durrani MIA, Naz T, Atif M, Khalid N, Amelio A. A semantic-based framework for verbal autopsy to identify the cause of maternal death. Appl Clin Inform 2021; 12 (04) 910-923
- 48 Walker RL, Shortreed SM, Ziebell RA. et al. Evaluation of electronic health record-based suicide risk prediction models on contemporary data. Appl Clin Inform 2021; 12 (04) 778-787
- 49 Organization WH. ICD-11 Implementation or Transition Guide. Geneva, Switzerland: World Health Organization; 2019
- 50 Milgrom J, Gemmill AW, Bilszta JL. et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord 2008; 108 (1-2): 147-157
- 51 Beydoun HA, Beydoun MA, Kaufman JS, Lo B, Zonderman AB. Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: a systematic review and meta-analysis. Soc Sci Med 2012; 75 (06) 959-975
- 52 Xie RH, He G, Koszycki D, Walker M, Wen SW. Prenatal social support, postnatal social support, and postpartum depression. Ann Epidemiol 2009; 19 (09) 637-643
- 53 Gjerdingen D, McGovern P, Attanasio L, Johnson PJ, Kozhimannil KB. Maternal depressive symptoms, employment, and social support. J Am Board Fam Med 2014; 27 (01) 87-96
- 54 Beck CT. Revision of the postpartum depression predictors inventory. J Obstet Gynecol Neonatal Nurs 2002; 31 (04) 394-402
- 55 Choi Y, Bishai D, Minkovitz CS. Multiple births are a risk factor for postpartum maternal depressive symptoms. Pediatrics 2009; 123 (04) 1147-1154
- 56 Ross LE, McQueen K, Vigod S, Dennis CL. Risk for postpartum depression associated with assisted reproductive technologies and multiple births: a systematic review. Hum Reprod Update 2011; 17 (01) 96-106
- 57 Bergink V, Laursen TM, Johannsen BM, Kushner SA, Meltzer-Brody S, Munk-Olsen T. Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study. Psychol Med 2015; 45 (16) 3481-3489
- 58 Kreutzer JS, Seel RT, Gourley E. The prevalence and symptom rates of depression after traumatic brain injury: a comprehensive examination. Brain Inj 2001; 15 (07) 563-576
- 59 Mercier RJ, Garrett J, Thorp J, Siega-Riz AM. Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort. BJOG 2013; 120 (09) 1116-1122
- 60 Vigod SN, Villegas L, Dennis CL, Ross LE. Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. BJOG 2010; 117 (05) 540-550