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

arXiv: https://arxiv.org/abs/2602.03886 · HTML: https://mlsanity.com/paper/2602.03886/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 4 of its 38 references that are in the map.
- First posted on arXiv 3 Feb 2026.

## Builds on (most cited first, 4 of 4)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Automatic diagnosis of the 12-lead ECG using a deep neural network](https://mlsanity.com/paper/1904.01949/) (2019)
- [Efficient fetal-maternal ECG signal separation from two channel maternal abdominal ECG via diffusion-based channel selection](https://mlsanity.com/paper/1702.02025/) (2017)

## Abstract (arXiv)

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.