Abstract

Modelling the risk of abnormal pregnancy-related outcomes such as stillbirth and preterm birth have been proposed in the past. Commonly they utilize maternal demographic and medical history information as predictors, and they are based on conventional statistical modelling techniques. In this study, we utilize state-of-the-art machine learning methods in the task of predicting early stillbirth, late stillbirth and preterm birth pregnancies. The aim of this experimentation is to discover novel risk models that could be utilized in a clinical setting. A CDC data set of almost sixteen million observations was used conduct feature selection, parameter optimization and verification of proposed models. An additional NYC data set was used for external validation. Algorithms such as logistic regression, artificial neural network and gradient boosting decision tree were used to construct individual classifiers. Ensemble learning strategies of these classifiers were also experimented with. The best performing machine learning models achieved 0.76 AUC for early stillbirth, 0.63 for late stillbirth and 0.64 for preterm birth while using a external NYC test data. The repeatable performance of our models demonstrates robustness that is required in this context. Our proposed novel models provide a solid foundation for risk prediction and could be further improved with the addition of biochemical and/or biophysical markers.

Highlights

  • Stillbirth is defined as a baby born without signs of life after a threshold around 20–22 weeks of gestation

  • Beside various earlier studies [7, 15, 27, 30], this investigation further establishes the role of machine learning models as tools that can generate risk prediction models that show improved clinical prediction power over a multivariate logistic regression model, which was used as a control and represents the current standard method

  • The ensemble models across three algorithms further improved the performance with late stillbirth

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Summary

Introduction

Stillbirth is defined as a baby born without signs of life after a threshold around 20–22 weeks of gestation. Stillbirth-related guidelines by the American College of Obstetricians and Gynecologists (ACOG) state that gestational age (GA) threshold for stillbirth is at GA week 20 [1]. Respective thresholds are defined for birthweight, which are partially in disagreement due to high co-occurrence of fetal growth restriction in stillbirth pregnancies [4]. Global stillbirth rate has been declining mainly due to progress made in so called developed regions while the highest rates and slowest decline is observed in Southern Asia and sub-Saharan Africa [4]. Globally less than 2% of stillbirths happen in developed regions, they represent almost 50% of the available clinical data and statistics [4]

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