Prediction of neonatal subgaleal hemorrhage using first stage of labor data: A machine-learning based model

Joshua Guedalia, Michal Lipschuetz, Lina Daoud-Sabag, Sarah M. Cohen, Michal NovoselskyPersky, Simcha Yagel, Ron Unger, Gilad Karavani

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Subgaleal hemorrhage (SGH) is a rare neonatal condition, mainly associated with instrumental delivery, mainly vacuum extractor (VE). The aim of this study was to develop a machine learning model that would allow a personalized prediction algorithm for Subgaleal hemorrhage (SGH) following vacuum extraction (VE), based on maternal and fetal variables collected during the first stage of labor. Materials and methods: A retrospective cohort study on data from a university affiliated hospital, recorded between January 2013 and February 2017. Balanced random forest algorithm was used to develop a machine learning model to predict personalized risk of the neonate developing SGH, in the eventuality that vacuum extraction was used during delivery. Results: During the study period, 35,552 term, singleton spontaneous or induced trials of labor deliveries were included in this study. Neonatal SGH following vacuum extraction (SGH-VE) occurred in 109 cases (0.3%). Two machine learning models were developed: a proof of concept model (model A), based on a cohort limited to the (n=2955) instances of vacuum extraction, and the clinical support model (model B), based on all spontaneous or induced trials of labor (n=35,552). The models stratified parturients into high- and low-risk groups for development of SGH-VE. Model A showed a 2-fold increase in the high-risk group of parturients compared to the low risk group (OR=2.76, CI 95% 1.85-4.11). In model B, a 4-fold increase in the odds of SGH was observed in the high-risk group of parturients compared to the low risk group (OR=4.2, CI 2.2-8.1), while identifying 90.8% (99/109) of the SGH cases. Conclusions: Our machine learning-based model stratified births to high or low risk for SGH, making it an applicable tool for personalized decision-making during labor regarding the application of VE. This model may contribute to improved neonatal outcomes.

Original languageEnglish
Article number102320
JournalJournal of Gynecology Obstetrics and Human Reproduction
Volume51
Issue number3
DOIs
StatePublished - Mar 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Masson SAS

Keywords

  • Machine learning
  • Personalized medicine
  • Prediction
  • Subgaleal hemorrhage
  • Vacuum assisted delivery
  • obstetrics

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