Managing psychiatric disorders, including depression, anxiety, and bipolar disorder, during pregnancy presents significant clinical challenges due to uncertainties surrounding medication safety and efficacy for both the mother and fetus. This study introduces a novel deep learning (DL)-based decision-support framework aimed at personalizing pharmacotherapy for pregnant patients diagnosed with psychiatric conditions. By leveraging electronic health records (EHRs), pharmacogenomic data, and advanced machine learning techniques, we developed a predictive neural network model capable of recommending precise drug classes and dosages tailored to individual patient profiles. Our methodology consisted of clearly defined sequential phases: problem definition, data collection, preprocessing, feature engineering, exploratory data analysis (EDA), model development, genetic data integration, validation, and deployment into clinical practice. Exploratory analysis revealed critical insights, identifying significant predictors of medication efficacy and side effects through visualizations including pair plots, correlation heatmaps, violin plots, and interactive scatter plots. The developed neural network model, optimized using rigorous hyperparameter tuning, exhibited high accuracy and robust predictive power, as evidenced by outstanding ROC-AUC and precision-recall performance metrics. Integration of pharmacogenomic data further improved predictive accuracy, demonstrating the model’s ability to capture complex genetic interactions influencing drug response variability. Rigorous validation through retrospective cohort studies confirmed the clinical applicability and reliability of our system. Ultimately, our decision-support tool provides clinicians with evidence-based, individualized medication strategies that effectively balance therapeutic outcomes and safety concerns during pregnancy. The application of this DL-driven personalized pharmacotherapy framework holds significant potential for enhancing clinical decision-making, improving maternal mental health, and minimizing risks to fetal development.
Cite this paper
Filippis, R. D. and Foysal, A. A. (2025). Deep Learning for Personalized Pharmacotherapy in Pregnant Women with Psychiatric Disorders. Open Access Library Journal, 12, e3512. doi: http://dx.doi.org/10.4236/oalib.1113512.
Rusner, M., Berg, M. and Begley, C. (2016) Bipolar Disorder in Pregnancy and Childbirth: A Systematic Review of Outcomes. BMC Pregnancy and Childbirth, 16, Article No. 331. https://doi.org/10.1186/s12884-016-1127-1
Paschetta, E., Berrisford, G., Coccia, F., Whitmore, J., Wood, A.G., Pretlove, S., et al. (2014) Perinatal Psychiatric Disorders: An Overview. American Journal of Obstetrics and Gynecology, 210, 501-509.e6. https://doi.org/10.1016/j.ajog.2013.10.009
Oyebode, F., Rastogi, A., Berrisford, G. and Coccia, F. (2012) Psychotropics in Pregnancy: Safety and Other Considerations. Pharmacology & Therapeutics, 135, 71-77. https://doi.org/10.1016/j.pharmthera.2012.03.008
Erdeljić, V., Francetić, I., Makar-Aušperger, K., Likić, R. and Radačić-Aumiler, M. (2010) Clinical Pharmacology Consultation: A Better Answer to Safety Issues of Drug Therapy during Pregnancy? European Journal of Clinical Pharmacology, 66, 1037-1046. https://doi.org/10.1007/s00228-010-0867-5
Eberhard-Gran, M., Eskild, A. and Opjordsmoen, S. (2005) Treating Mood Disorders during Pregnancy. Drug Safety, 28, 695-706. https://doi.org/10.2165/00002018-200528080-00004
Nguyen, T., Seiler, N., Brown, E. and O’Donoghue, B. (2020) The Effect of Clinical Practice Guidelines on Prescribing Practice in Mental Health: A Systematic Review. Psychiatry Research, 284, Article ID: 112671. https://doi.org/10.1016/j.psychres.2019.112671
Galbally, M., Frayne, J., Watson, S.J. and Snellen, M. (2019) Psy-chopharmacological Prescribing Practices in Pregnancy for Women with Severe Mental Illness: A Multicentre Study. Euro-pean Neuropsychopharmacology, 29, 57-65. https://doi.org/10.1016/j.euroneuro.2018.11.1103
Yonkers, K.A., Wisner, K.L., Stewart, D.E., Oberlander, T.F., Dell, D.L., Stotland, N., et al. (2009) The Management of Depression during Pregnancy: A Report from the American Psychiatric Association and the American College of Obstetricians and Gynecol-ogists. General Hospital Psychiatry, 31, 403-413. https://doi.org/10.1016/j.genhosppsych.2009.04.003
McAllister-Williams, R.H., Baldwin, D.S., Cantwell, R., Easter, A., Gilvarry, E., Glover, V., et al. (2017) British Association for Psychopharmacology Consensus Guidance on the Use of Psy-chotropic Medication Preconception, in Pregnancy and Postpartum 2017. Journal of Psychopharmacology, 31, 519-552. https://doi.org/10.1177/0269881117699361
Ortega, V.E. and Meyers, D.A. (2014) Pharmacogenetics: Implications of Race and Ethnicity on Defining Genetic Profiles for Personalized Medicine. Journal of Allergy and Clinical Immunology, 133, 16-26. https://doi.org/10.1016/j.jaci.2013.10.040
Ette, E.I. and Williams, P.J. (2004) Population Pharmacoki-netics I: Background, Concepts, and Models. Annals of Pharmacotherapy, 38, 1702-1706. https://doi.org/10.1345/aph.1d374
Diekstra, M., Fritsch, A., Kanefendt, F., Swen, J., Moes, D., Sörgel, F., et al. (2017) Population Modeling Integrating Pharmacokinetics, Pharmacodynamics, Pharmacogenetics, and Clinical Outcome in Patients with Sunitinib-Treated Cancer. CPT: Pharmacometrics & Systems Pharmacology, 6, 604-613. https://doi.org/10.1002/psp4.12210
Marques, L., Costa, B., Pereira, M., Silva, A., Santos, J., Saldanha, L., et al. (2024) Advancing Precision Medicine: A Review of Innovative in Silico Approaches for Drug Development, Clinical Pharmacology and Personalized Healthcare. Pharmaceutics, 16, Article 332. https://doi.org/10.3390/pharmaceutics16030332
Primorac, D., Bach-Rojecky, L., Vađunec, D., Juginović, A., žunić, K., Matišić, V., et al. (2020) Pharmacogenomics at the Center of Precision Medicine: Chal-lenges and Perspective in an Era of Big Data. Pharmacogenomics, 21, 141-156. https://doi.org/10.2217/pgs-2019-0134
Xiao, C., Choi, E. and Sun, J. (2018) Opportunities and Challenges in De-veloping Deep Learning Models Using Electronic Health Records Data: A Systematic Review. Journal of the American Medical Informatics Association, 25, 1419-1428. https://doi.org/10.1093/jamia/ocy068
Ahmed, Z., Mohamed, K., Zeeshan, S. and Dong, X. (2020) Artificial Intelligence with Multi-Functional Machine Learning Platform Development for Better Healthcare and Precision Medicine. Database, 2020, baaa010. https://doi.org/10.1093/database/baaa010
Zafar, I., Anwar, S., kanwal, F., Yousaf, W., Un Nisa, F., Kausar, T., et al. (2023) Reviewing Methods of Deep Learning for Intelligent Healthcare Systems in Genomics and Biomedicine. Biomedical Signal Processing and Control, 86, Article ID: 105263. https://doi.org/10.1016/j.bspc.2023.105263
Bennett, R., Hemmati, M., Ramesh, R. and Razzaghi, T. (2024) Artificial Intelligence and Machine Learning in Precision Health: An Overview of Meth-ods, Challenges, and Future Directions. In: Kotsireas, I.S., Nagurney, A., Pardalos, P.M., Pickl, S.W. and Vogiatzis, C., Eds., Dynamics of Disasters, Springer, 15-53. https://doi.org/10.1007/978-3-031-74006-0_2
Sharmila, K.S. and Chandra, K.R. (2024) Predicting Adverse Interactions: A Comprehensive Review of Ai-Driven Drug-Drug Interaction Models for En-hanced Patient Safety. 2024 International Conference on IoT Based Control Networks and Intelligent Systems (ICICNIS), Bengaluru, 17-18 December 2024, 1098-1102. https://doi.org/10.1109/icicnis64247.2024.10823221
Iqbal, A.B., Shah, I.A., Injila, Assad, A., Ahmed, M. and Shah, S.Z. (2024) A Review of Deep Learning Algorithms for Modeling Drug Interactions. Multimedia Systems, 30, Article No. 124. https://doi.org/10.1007/s00530-024-01325-9
Ibrahim, A.A., Mohammed, T.A. and Dara, O.N. (2024) Predicting Big Data Drug Interactions and Associated Side Effects by Using Artifi-cial Neural Networks (ANN) over Traditional Graph Convolutional Networks (GCNs). https://doi.org/10.21203/rs.3.rs-3997856/v1
Mak, K., Wong, Y. and Pichika, M.R. (2024) Artificial Intelligence in Drug Discovery and Development. In: Hock, F.J. and Pugsley, M.K., Eds., Drug Discovery and Evaluation: Safety and Phar-macokinetic Assays, Springer, 1461-1498. https://doi.org/10.1007/978-3-031-35529-5_92
Shastry, B.S. (2005) Pharmacogenetics and the Concept of Individualized Medicine. The Pharmacogenomics Journal, 6, 16-21. https://doi.org/10.1038/sj.tpj.6500338
Ilan, Y. (2022) Next-Generation Personalized Medicine: Implementation of Variability Patterns for Overcoming Drug Resistance in Chronic Diseases. Journal of Personalized Medicine, 12, Article 1303. https://doi.org/10.3390/jpm12081303
Pittman, J., Huang, E., Dressman, H., Horng, C., Cheng, S.H., Tsou, M., et al. (2004) Integrated Modeling of Clinical and Gene Expression Information for Personalized Prediction of Disease Out-comes. Proceedings of the National Academy of Sciences of the United States of America, 101, 8431-8436. https://doi.org/10.1073/pnas.0401736101
Chen, Y., Hsiao, T., Lin, C. and Fann, Y.C. (2025) Unlocking Precision Medicine: Clinical Applications of Integrating Health Records, Genetics, and Immunology through Artificial Intelligence. Journal of Biomedical Science, 32, Article No. 16. https://doi.org/10.1186/s12929-024-01110-w
Castaneda, C., Nalley, K., Mannion, C., Bhattacharyya, P., Blake, P., Pecora, A., et al. (2015) Clinical Decision Support Systems for Improving Diag-nostic Accuracy and Achieving Precision Medicine. Journal of Clinical Bioinformatics, 5, Article No. 4. https://doi.org/10.1186/s13336-015-0019-3
Samson Enitan, S., Ngozi Adejumo, E., Osaigbovoh Imaralu, J., Ademola Adelakun, A., Anike Ladipo, O. and Bosede Enitan, C. (2023) Personalized Medicine Approach to Osteoporosis Management in Women: Integrating Genetics, Pharmacogenomics, and Precision Treatments. Clinical Research Communications, 6, Arti-cle 18. https://doi.org/10.53388/crc2023018
von Dadelszen, P., Magee, L.A., Payne, B.A., Dunsmuir, D.T., Drebit, S., Dumont, G.A., et al. (2015) Moving Beyond Silos: How Do We Provide Distributed Personalized Medicine to Pregnant Women Everywhere at Scale? Insights from Pre-Empt. International Journal of Gynecology & Obstetrics, 131, S10-S15. https://doi.org/10.1016/j.ijgo.2015.02.008
Delanerolle, G., Yang, X., Shetty, S., Raymont, V., Shetty, A., Phiri, P., et al. (2021) Artificial Intelligence: A Rapid Case for Advancement in the Personalization of Gynaecology/Obstetric and Mental Health Care. Women’s Health, 17. https://doi.org/10.1177/17455065211018111
Ghanem, M., Ghaith, A.K. and Bydon, M. (2024) Artificial Intelligence and Personalized Medicine: Transforming Patient Care. In: Bydon, M., Ed., The New Era of Precision Medicine, Elsevier, 131-142. https://doi.org/10.1016/b978-0-443-13963-5.00012-1
Schork, N.J. (2019) Artificial Intelligence and Personalized Medicine. In: Von Hoff, D. and Han, H., Eds., Precision Medicine in Cancer Therapy, Springer, 265-283. https://doi.org/10.1007/978-3-030-16391-4_11
Sahu, M., Gupta, R., Ambasta, R.K. and Kumar, P. (2022) Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis. Progress in Molecular Biology and Translational Science, 190, 57-100. https://doi.org/10.1016/bs.pmbts.2022.03.002
Costa, B. and Vale, N. (2024) Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring. Journal of Clinical Medicine, 13, Article 4398. https://doi.org/10.3390/jcm13154398
Porter, I., Gonçalves-Bradley, D., Ricci-Cabello, I., Gibbons, C., Gangannagaripalli, J., Fitzpatrick, R., et al. (2016) Framework and Guidance for Implementing Patient-Reported Outcomes in Clinical Practice: Evidence, Challenges and Opportunities. Journal of Comparative Effectiveness Research, 5, 507-519. https://doi.org/10.2217/cer-2015-0014
Kent, D.M., Steyerberg, E. and van Klaveren, D. (2018) Personalized Evidence Based Medicine: Predictive Approaches to Heterogeneous Treatment Effects. BMJ, 363, k4245. https://doi.org/10.1136/bmj.k4245
Cohen, A.M., Stavri, P.Z. and Hersh, W.R. (2004) A Categorization and Analysis of the Criticisms of Evidence-Based Medicine. International Journal of Medical Informatics, 73, 35-43. https://doi.org/10.1016/j.ijmedinf.2003.11.002
Weiner, S.J., Schwartz, A., Weaver, F., Goldberg, J., Yudkowsky, R., Sharma, G., et al. (2010) Contextual Errors and Failures in Individualizing Patient Care. Annals of Internal Medicine, 153, 69-75. https://doi.org/10.7326/0003-4819-153-2-201007200-00002
Chekroud, A.M., Bondar, J., Delgadillo, J., Doherty, G., Wasil, A., Fokkema, M., Cohen, Z., et al. (2021) The Promise of Machine Learning in Predicting Treatment Outcomes in Psychiatry. World Psychiatry, 20, 154-170. https://doi.org/10.1002/wps.20882
de Pablo, S., et al. (2021) Implementing Precision Psychiatry: A Systematic Review of Individualized Prediction Models for Clinical Practice. Schizophrenia Bulletin, 47, 284-297. https://doi.org/10.1093/schbul/sbaa120
Garriga, R., Mas, J., et al. (2022) Machine Learning Model to Predict Mental Health Crises from Electronic Health Records. Nature Medicine, 28, 1240-1248. https://doi.org/10.1038/s41591-022-01811-5
Shickel, B., Tighe, P.J., Bihorac, A. and Rashidi, P. (2018) Deep EHR: A Survey of Recent Advances in Deep Learning Techniques for Electronic Health Record (EHR) Analysis. IEEE Journal of Biomedical and Health Informatics, 22, 1589-1604. https://doi.org/10.1109/jbhi.2017.2767063
Tong, L., Shi, W., Isgut, M., Zhong, Y., Lais, P., Gloster, L., et al. (2024) Integrating Multi-Omics Data with EHR for Precision Medicine Using Advanced Artificial Intelligence. IEEE Reviews in Biomedical Engineering, 17, 80-97. https://doi.org/10.1109/rbme.2023.3324264
Ross, N.E., Webster, T.G., et al. (2022) Reproductive Decision-Making Capacity in Women with Psychiatric Illness: A Systematic Review. Journal of the Academy of Consultation-Liaison Psychiatry, 63, 61-70. https://doi.org/10.1016/j.jaclp.2021.08.007
Hippman, C.L. (2020) Promoting Perinatal Mental Health: Personalizing Treatment Decision Making Strategies through Decision-Making Support and Pharmacogenetics. Ph.D. Thesis, University of British Columbia.
Wisner, K.L., Zarin, D.A., Holmboe, E.S., Appelbaum, P.S., Gelenberg, A.J., Leonard, H.L., et al. (2000) Risk-Benefit Decision Making for Treatment of Depression during Pregnancy. American Journal of Psychi-atry, 157, 1933-1940. https://doi.org/10.1176/appi.ajp.157.12.1933
Carlin, A. and Alfirevic, Z. (2008) Physiologi-cal Changes of Pregnancy and Monitoring. Best Practice & Research Clinical Obstetrics & Gynaecology, 22, 801-823. https://doi.org/10.1016/j.bpobgyn.2008.06.005
Tobore, I., Li, J., Yuhang, L., Al-Handarish, Y., Kandwal, A., Nie, Z., et al. (2019) Deep Learning Intervention for Health Care Challenges: Some Biomedical Domain Considerations. JMIR mHealth and uHealth, 7, e11966. https://doi.org/10.2196/11966
Morid, M.A., Sheng, O.R.L. and Dunbar, J. (2023) Time Series Prediction Using Deep Learning Methods in Healthcare. ACM Transactions on Management Information Sys-tems, 14, 1-29. https://doi.org/10.1145/3531326
Wang, Y., Liu, L. and Wang, C. (2023) Trends in Using Deep Learning Algorithms in Biomedical Prediction Systems. Frontiers in Neuroscience, 17, Article 1256351. https://doi.org/10.3389/fnins.2023.1256351
Howard, L.M. and Khalifeh, H. (2020) Perinatal Mental Health: A Re-view of Progress and Challenges. World Psychiatry, 19, 313-327. https://doi.org/10.1002/wps.20769
Brockington, I., Butterworth, R. and Glangeaud-Freudenthal, N. (2016) An International Position Paper on Mother-Infant (Perinatal) Mental Health, with Guidelines for Clinical Practice. Archives of Women’s Mental Health, 20, 113-120. https://doi.org/10.1007/s00737-016-0684-7
Epstein, R., Moore, K. and Bobo, W. (2014) Treatment of Bipolar Dis-orders during Pregnancy: Maternal and Fetal Safety and Challenges. Drug, Healthcare and Patient Safety, 7, 7-29. https://doi.org/10.2147/dhps.s50556
Fisher, J. and Stocky, A. (2003) Maternal Perinatal Mental Health and Multi-ple Births: Implications for Practice. Twin Research, 6, 506-513. https://doi.org/10.1375/136905203322686509