Abstract

Mortality remains an exceptional burden of extremely preterm birth. Current clinical mortality prediction scores are calculated using a few static variable measurements, such as gestational age, birth weight, temperature, and blood pressure at admission. While these models do provide some insight, numerical and time-series vital sign data are also available for preterm babies admitted to the NICU and may provide greater insight into outcomes. Computational models that predict the mortality risk of preterm birth in the NICU by integrating vital sign data and static clinical variables in real time may be clinically helpful and potentially superior to static prediction models. However, there is a lack of established computational models for this specific task. In this study, we developed a novel deep learning model, DeepPBSMonitor (Deep Preterm Birth Survival Risk Monitor), to predict the mortality risk of preterm infants during initial NICU hospitalization. The proposed deep learning model can effectively integrate time-series vital sign data and fixed variables while resolving the influence of noise and imbalanced data. The proposed model was evaluated and compared with other approaches using data from 285 infants. Results showed that the DeepPBSMonitor model outperforms other approaches, with an accuracy, recall, and AUC score of 0.888, 0.780, and 0.897, respectively. In conclusion, the proposed model has demonstrated efficacy in predicting the real-time mortality risk of preterm infants in initial NICU hospitalization.

Highlights

  • One in ten babies are born prematurely in the United States[1], and the complications of preterm birth are the leading cause of infant death[2,3]

  • The Transport Risk Index of Physiologic Stability, Version II (TRIPS-II)[13] uses temperature, blood pressure, respiratory status, and response to noxious stimuli as predictor variables—this measure was validated in 17,075 infants admitted between 2006 and 2008

  • A total of 6271 infants were admitted to the neonatal intensive care unit (NICU), 1465 of which met GA and weight criteria to be considered a very low birth weight (VLBW) infant

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Summary

Introduction

One in ten babies are born prematurely (defined as birth before 37 completed weeks of pregnancy) in the United States[1], and the complications of preterm birth are the leading cause of infant death[2,3]. Mortality is concentrated primarily among very low birth weight (VLBW) preterm infants (those weighing 100,000 cases between 2010 and 2017

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