2023 International Conference for Advancement in Technology (ICONAT)
Goa, India. Jan 24-26, 2023
Early Prediction of Maternal Health Risk Factors
Using Machine Learning Techniques
1st MD Assaduzzaman 2nd Abdullah Al Mamun
Dept. of CSE Dept. of CSE
Daffodil International University Daffodil International University
2023 International Conference for Advancement in Technology (ICONAT) | 978-1-6654-7517-4/23/$31.00 ©2023 IEEE | DOI: 10.1109/ICONAT57137.2023.10080700
Dhaka, Bangladesh Dhaka, Bangladesh
assaduzzaman.cse@diu.edu.bd mamun.cse@diu.edu.bd
Abstract—Nowadays, maternal health issues are one of the
most challenging issues all over the world. Many women die
each year during pregnancy and after delivery, which is a
major cause of infant mortality. In rural areas,pregnant women
face various difficulties and challenges, including a shortage
of doctors, inadequate knowledge, a lack of public clinics,
infrastructure issues, and transportation issues. The mother’s
pregnancy is the major cause of the infant’s poor health, rather
than any other factors that may have arisen after childbirth.
Significant roles are played by maternal risk factors such
as the mother’s chronic condition, age, nutrition, and other
medical assistance during pregnancy. Recent developments in
Artificial intelligence methods, particularly machine learning
models, have made it easier to make predictions in a variety of
disciplines. We can identify the primary maternal risk factors
that can lead to newborn child and maternal mortality using
machine learning techniques. This paper proposes improved
data preprocessing methods that involve feature engineering
and data cleaning in order to effectively handle anomalies in the
data values. To identify the maternal health risk factor, several
machine learning algorithms were used, including Cat Boost,
Random Forest, XGB, Decision Tree, and Gradient Boost. Using
the preprocessed dataset, the suggested model was developed,
trained, and tested. The Random Forest was the best machine-
learning algorithm with an accuracy score of 90%, precision
(90%), recall (90%), and F1-score (90%)
Index Terms—Random Forest, Maternal Health, Risk Fac-
tors, Machine Learning, Classification
I. I NTRODUCTION
Fatal Maternal Risk of complications is a term used to
describe a range of problems that could have a serious
influence on a woman’s and her children’s health and occur
during maternity, birth, or the postnatal period. If some of
these symptoms appear, the patient must seek medical help
as soon as possible to avoid death. Approximately 585.000
women die every year in the world during childbirth, the
postpartum period, or delivery [1], and nearly 50 million
maternal and infant difficulties are reported each year, with
around 300 million women affected by long-term and short-
term medical complications associated with pregnancy, de-
livery, and postpartum [2]. Women in rural locations and
impoverished communities have the highest maternal death
rates. Pregnancy-related complications and maternal mortal-
ity are more common among young teenage girls (10–14
years old). Maternal mortality is far too common. Around
295 000 women lost their lives in 2017 due to complications
related to pregnancy or childbirth [3].A significant proportion
of deaths (94%) occurred in lowland areas, and many of them
might have been prevented. An estimated 86% of all maternal
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3rd Md Zahid Hasan
Health Informatics Research Lab,Dept. of CSE
Daffodil International University
Dhaka, Bangladesh
zahid.cse@diu.edu.bd
deaths in 2017 occurred in Southern Asia and Sub-Saharan
Africa (254000) [4]. Every day in 2017, almost 830 women
died from maternity and childbirth-related conditions that
could have been prevented. Nearly all maternal deaths (94%
worldwide) take place in middle and low-income countries.
The rate of maternal mortality in Bangladesh is 245 per
every 100,000 live births. An estimated 7,660 women per
year in Bangladesh die from complications during pregnancy
that could have been avoided [5]. The maternal deaths and
mortality rates in Cox’s Bazar, a rural area in the southeast,
are among the highest in the nation. 90% pregnancy of
women in this region give birth due to a lack of healthcare
services without the assistance of a skilled birth attendant
or the provision of emergency treatment. Additionally, more
than 50 percent of all pregnant women have no access to
the medical services that are available to them, and 11% of
women consult a doctor in the first 6 weeks that followed de-
livery. About 36 percent of the total pregnant women receive
any kind of prenatal care from a qualified physician (WHO,
2017. Bangladesh also suffers from a scarcity of trained
birth attendants, especially in rural regions (DHS 2014) [4].
Maternal deaths, which account for 14% of all deaths among
Bangladeshi women aged 15 to 49, are the third leading cause
of death [6]. Qualified labor and strong pregnancy care and
delivery attendance could avert the majority of these deaths.
However, because we do not have all of the correct mortality
figures, this estimate might be significantly higher. If women
and newborns are given competent care before, during, and
after birth, they can be saved.
That’s why new approaches for early detection and anal-
ysis of maternal health incidents are required. This paper
proposes using machine learning techniques to make a risk
classifier for maternal mortality. As a result, we hope to have
early diagnosis of morbidity instances, as well as medical
experts making decisions, allowing for timely patient treat-
ment.This might help reduce the chances to the mother and
infant mortality within this period as well as the social and
economic consequences.
II. L ITERATURE R EVIEW
Prophylaxis lowers the chances of getting sick, and early
detection raises the chances of simple and quick treatment.
Curable infections and risks are the cause of the deaths of
many pregnant women. It is not uncommon for a pregnant
woman’s disease to go undiagnosed, or for the risks that she
faces to go unnoticed. Various machine learning approaches
1
and various data mining techniques are now being utilized
to predict and find various diseases and dangers in pregnant
women. The great accuracy of these methods has been
proven, and it has a positive impact on maternal morbidity
and mortality ratios in many circumstances The authors of
[7] use machine learning approaches to diagnose and treat
newborn sepsis early and more effectively. Predictive models
were created using data that was collected on a regular basis.
Further optimization of Machine Learning models, according
to the author, could provide a conclusion for randomized
clinical studies. Poon et al. [8] present research on the
early detection of hypertensive problems during the first
three months of pregnancy in the London population. Acute
maternal morbidity can be predicted. Early 261A detection
rate of roughly 90% for early pregnancy was determined
using logistic regression, with a 5 percent false positive
rate Park et al. [9] offer a multivariate logistic regression
strategy for predicting the risk of pregnancy in an Australian
population. With a 10% false positive rate, the system
successfully diagnosed preeclampsia in 95% of women.
Based on biomarkers and some maternal factors, Nanda
et al. [10] develop a model for predicting diabetes during
pregnancy in the first trimester of pregnancy. They were
able to make 74.1 percent valid predictions using logistic
regression, with a 20% false positive rate. Diabetes, hyperten-
sion, and illness can all be predicted, Farran et al. [11] used
methods including logistic regression, different factor model
dimension reduction, support vector machines, and k-nearest
neighbors (k-NN). The procedures were successfully exe-
cuted, yielding identical results. To determine complicated
factors that caused neonatal mortality, the author of [12]
study uses a Bayesian network (network of factors causing
mortality rate, including maternal morbidity and mortality,
premature births, breathing at birth, and movement.) The
study employs logistic regression analysis and algorithms
to evaluate the average causal influence and find previously
unknown determinants and pathways using measurements
from the Children’s Health Registry. The author of the [13]
paper describes analytical methods that employ a machine
learning approach to construct models that estimate the risk
of bad pregnancy outcomes as a consequence of existing
data by identifying relevant risk factors. The outcomes of
the SOM algorithm found that low birth weight, early birth,
availability to prenatal care, and other factors are linked to
infant deaths. The author of [14] this study uses a two-level
study on child mortality to take into account how the data
is set up in a hierarchy. The findings reveal that commu-
nity/state variables continue to play a significant effect in
newborn mortality in India. A three-level model is used in the
analytical procedures. A suitable epidemiological perception
at regular periods may be valuable for policymakers at the
regional level. Kenny et al. [15] wanted to establish a pre-
eclampsia disorder prognosis for pregnant women. Using 97
plasma samples, to verify the patterns of metabolites that
distinguish pre-eclampsia patients’ fluid, they used genetic
programming. The authors of [16] developed a logistic model
that can predict severe morbidity in the early stages of
pregnancy. The system is predicated based on a community
of pregnant women who receive postpartum period care at the
Maternidad hospital in Cartagena. The authors of [17] devel-
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oped a preterm neonate’s survival evaluation using machine-
learning techniques. It demonstrates that a machine-learning
technique outperforms logistic models in predicting survival
in extremely preterm newborns. The authors of [18] provide
a model for predicting hypertension problems during the first
trimester of pregnancy based on the London population. The
suggested model has a 90% overall accuracy and a 5% false-
positive rate. The authors [19] used a hybrid approach that
also included K- nearest neighbor, logistic regression, and
multi-variable dimension reduction, support vector machines
to predict blood sugar levels, associated symptoms, and high
blood pressure Yarlapati [20] et al. used machine learning
techniques to estimate the risk of having a premature baby
in a pregnancy, which is a crucial indicator of the state of
the fetus. Using the clinical data of Indian newborns, they
were able to identify with 96.77 percent accuracy whether
the infants were NOT-LBW or LBW using the Bayes lowest
error rate classifier. In another study [21], ultrasonography
pictures of pregnant individuals’ lumbar spines were used to
establish the optimal needle surgical site. The interspinous
region is located by means of a Support Vector Machine
equipped with a Gaussian kernel. The suggested model was
evaluated with 640 photographs from the second group of
16 preterm infants after training with 800 images from 20
female individuals, and it attained achievement of 95.00
percent. Cheng [22] et al. investigated how risk factors like
hematocrit and age affected the gestational age of pregnant
women. The most important area of research is that recog-
nized risk factors impact in 412 pregnant women with 1874
clinical follow-up records, prenatal hypertension and pre-
eclampsia were treated differently. Woolery and Grzymala
Busse [23] investigated how to determine the likelihood of
preterm delivery. They employed 18,890 participants and 214
variables to create an intelligent system for evaluating the
risk of preterm birth. Their suggested strategy had a 53–88%
success rate in predicting premature birth for 9419 patients.
Prior machine learning techniques include the Naive Bayes
approach and the C4.5 classification of decision trees model
learning approaches in clinical diagnosis and monitoring,
with uses such as predicting and presenting gestational
risks [24]. Kenny [25] et al. wanted to establish a pre-
eclampsia syndrome prognosis for pregnant women. They
used genetic algorithms to confirm the chemical sequences
that distinguish plasma from people with pre-eclampsia using
97 serum samples. In their neonatal CTG analysis, Krupa et
al. [26] employed empirical mode segmentation and SVM.
On 90 randomly chosen records, 86 percent accuracy was
attained in predicting typical or at-risk classes. An IoT-based
model with 97% accuracy was proposed by the author in
[27] to examine the risk factors for maternal health risk in
Bangladesh. As a result, we may be able to use various data
and machine learning techniques to forecast and identify the
risk level of any and all diseases that cause maternal and
neonatal mortality in pregnant women.
III. M ETHODOLOGY
The methodology of our study will be covered in this
section, along with the data collection and preprocessing
steps and an overview of the suggested models that were
used for analysis and risk factor prediction.
 Fig. 2. Risk Level Distribution

The first step in processing the dataset was to look for any
missing values. The dataset does not contain any missing
values

Fig. 1. Methodology of the proposed system.

A. Dataset Collection
In this experiment, the maternal health risk factors dataset
[28] was collected from the repository of UCI machine
learning, which is publicly available. It contains 1014 rows
and 7 columns. The majority of pregnant women in this
dataset have low health risks. Out of 1014 observations, 406
(40%) pregnant women were at low risk, 336 (33.1%) were
Fig. 3. The heat map for correlation features of the dataset.
at medium risk, and 272 (26.8%) were at high risk. The entire
set of attributes and their information are given below:
Age: When a woman is pregnant, she might be any age in C. Feature Engineering and Data cleaning
years.
In this dataset, “Heart Rate” is the only variable having
Systolic BP: The maximum blood pressure in millimeters
an anomaly with an irrational value. Two observations in
of mercury, is another crucial element to take into account
this variable had heart rates of 7 beats per minute (beats per
while pregnant.
minute). We all know that the average resting heart rate for
Diastolic BP: A lower blood pressure measurement in mil-
individuals over the age of ten, including older individuals,
limeters of mercury is an additional aspect to consider during
ranges between 60 and 100 beats per minute. It’s possible
pregnancy.
that the data may not be reliable because of an input error. It
BS: The amount of glucose in the blood is measured in
is feasible that the given label is incorrect, which will confuse
mmol/L.
the training process and reduce the accuracy of the model.
Heart rate: The normal number of beats per minute for a
That’s why we have dropped the Heart Rate variable.
heart rate
Risk Level: Risk Prediction Intensity level during pregnancy D. Dataset Splitting
depends on the preceding attribute. In order to use any machine learning technique, the dataset
In this case, the target variable is risk level, while the other must be divided into two parts such as training and testing.
features are predictor variables. 80% of the data in this dataset was used to model training,
while the remaining 20% was used for test the model.
B. Data Preprocessing
In order to build a better prediction model, one needs to E. Machine Learning Model
first prepare the data ready for analysis. The model’s effec- The following segment contains a list of some of the
tiveness increases when the data are transformed properly. most widely used data mining strategies for the pattern as

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well as classification recognition. There are multiple different IV. RESULTS AND DISCUSSION
machine learning algorithms that can be performed in the
prediction of the risk factor of maternal health. The following This study used five different machine learning techniques
5 types of Machine Learning algorithms were used to make to predict factors affecting maternal health. The purpose of
predictions and analyze data: this study was to compare several machine learning models
• Random Forest [29]. in order to develop a more effective predictive model. This
• Decision Tree [30]. section looks at how well different machine learning models
• Cat Boost [31]. work based on a number of different metrics. Five different
• XGB [32]. types of evaluation metrics were used to figure out how well
• Gradient boosting [33]. the models worked: ”Recall, Precision, Accuracy, as well as
F1-Score”
F. Performance Measurements Here we also compare the classification report of the
raw dataset and preprocessed dataset. Before performing
In this section, we’ll compare how well our proposed feature engineering and data cleaning, Table 1 shows the
methods comparative experiments were done in accordance performance measures of a different classification algorithm.
with the two editions of the dataset on maternal health risk After performing feature engineering and data cleaning,
factors: 1. original 2. Preprocessed dataset.The five classifiers Table 2 summarizes the performance indicators of various
were applied to each dataset separately to generate training classification systems.We observed an improvement in test
models, and those classifiers are Random Forest, Decision data accuracy when we used our processed dataset. It demon-
Tree, XGB, Cat Boost, and Gradient Boost and a 80%—20% strates that our model generalizes more effectively with our
splitting were used to train and test each machine learning processed dataset. Four types of assessment measures were
model. The effectiveness of various machine learning models used to evaluate the models’ performance: ”Recall, Precision,
is evaluated using indicators like: Accuracy, and F1-score for each model given in Table 2
Confusion Matrix – It is a table that is frequently utilized
in the process of describing the effectiveness of classifi-
TABLE I
cation models. Classification performance may mislead if B EFORE FEATURE ENGINEERING AND DATA CLEANING
dataset contains more than two classes or if the number
of observations in each class is unbalanced. True positives, Algorithm Accuracy Precision Recall F1 Score
false positives, false negatives, and true negatives are the Random
87% 87% 87% 87%
Forest
four major types used to build the confusion matrix [34].
Decision
Accuracy: It is a statistic that is used in classification issues 85% 85% 85% 85%
Tree
to identify what proportion of predictions are accurate Cat
84% 84% 84% 84%
Boosting
TP + TN
Accuracy = (1) XGB 83% 83% 83% 83%
TP + FN + FP + TN Gradient
80% 80% 80% 80%
Boosting
Precision: The percentage of correctly recognized positive
samples in relation to the overall number of positively
identified samples is referred to as precision.
TABLE II
TP
P recision = (2) A FTER FEATURE ENGINEERING AND DATA CLEANING
TP + FP
Algorithm Accuracy Precision Recall F1 Score
Recall: For each positive sample, the recall is determined by Random
the percentage of true positives out of all true positives. 90% 90% 90% 90%
Forest
Decision
TP Tree
87% 87% 87% 87%
Recall = (3)
TP + FN Cat
86% 86% 86% 86%
Boosting
F1 score: The F1 score is a statistic that takes the harmonic XGB 85% 86% 85% 85%
mean of a classification system’s precision and recalls values Gradient
81% 82% 81% 81%
and combines them into a single value. Boosting

(P recisionxRecall)
F 1 = 2x (4) It was noticed that ”Random Forest” was the best machine-
(P recision + Recall)
learning algorithm, with an accuracy score of 90%, precision
Where, TP = True Positive, TN = True Negative (90%), recall (90%), and F1-score (90%)
We can easily determine the risk level of maternal health,
FN whether it is high, mid, or low.Five different machine learn-
FNR = = 1 − TPR (5)
TP + FN ing algorithms were implemented in this work, with Random
Forest provides the highest accuracy for proper classification.
FP The following figure demonstrate the accuracy of correctly
FPR = = 1 − TPR (6) identifying the risk level of maternal health.
TN + FP

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Fig. 4. Risk prediction result of Random Forest model
Fig. 5. Normalized Confusion matrix of Random Forest model
Fig. 6. Significant risk factors during pregnancy
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As Random forest provides the highest accuracy, we
can select the Random forest Classifier to get the feature
importance. We can see that from the above figure, Blood
sugar is the main key factor as it has a big impact on the
classification result and and the Age is second most risk
factor.
V. C ONCLUSION
Several different classification strategies for predicting
potential risks to maternal health have been described in
this article. For the purpose of forecasting the risk factor,
the classification method of Random Forest with hyper-
parameter tuning performs significantly better than the other
classification methods that are currently in use, including
Decision trees, cat boost, XGB, and Gradient boosting.
Random forest with hyper-parameter tuning provides the
highest accuracy of 90%, Precision 90%, Recall 90% and
F1 score 90%. Blood sugar is the first the key factor in
these studies since it has a big impact on the classification
outcome, while age is the second major factor. In future,
we will include more features (Risk Factors) to allow for a
more comprehensive study and research on mother and infant
health and immunology
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