Kember Allan J, Selvarajan Rahavi, Park Emma, Huang Henry, Zia Hafsa, Rahman Farhan, Akbarian Sina, Taati Babak, Hobson Sebastian R, Dolatabadi Elham
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada.
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
PLOS Digit Health. 2023 Oct 3;2(10):e0000353. doi: 10.1371/journal.pdig.0000353. eCollection 2023 Oct.
In 2021, the National Guideline Alliance for the Royal College of Obstetricians and Gynaecologists reviewed the body of evidence, including two meta-analyses, implicating supine sleeping position as a risk factor for growth restriction and stillbirth. While they concluded that pregnant people should be advised to avoid going to sleep on their back after 28 weeks' gestation, their main critique of the evidence was that, to date, all studies were retrospective and sleeping position was not objectively measured. As such, the Alliance noted that it would not be possible to prospectively study the associations between sleeping position and adverse pregnancy outcomes. Our aim was to demonstrate the feasibility of building a vision-based model for automated and accurate detection and quantification of sleeping position throughout the third trimester-a model with the eventual goal to be developed further and used by researchers as a tool to enable them to either confirm or disprove the aforementioned associations. We completed a Canada-wide, cross-sectional study in 24 participants in the third trimester. Infrared videos of eleven simulated sleeping positions unique to pregnancy and a sitting position both with and without bed sheets covering the body were prospectively collected. We extracted 152,618 images from 48 videos, semi-randomly down-sampled and annotated 5,970 of them, and fed them into a deep learning algorithm, which trained and validated six models via six-fold cross-validation. The performance of the models was evaluated using an unseen testing set. The models detected the twelve positions, with and without bed sheets covering the body, achieving an average precision of 0.72 and 0.83, respectively, and an average recall ("sensitivity") of 0.67 and 0.76, respectively. For the supine class with and without bed sheets covering the body, the models achieved an average precision of 0.61 and 0.75, respectively, and an average recall of 0.74 and 0.81, respectively.
2021年,皇家妇产科学院国家指南联盟审查了相关证据,包括两项荟萃分析,这些证据表明仰卧睡眠姿势是生长受限和死产的一个风险因素。虽然他们得出结论,建议孕妇在妊娠28周后避免仰卧入睡,但他们对证据的主要批评是,迄今为止,所有研究都是回顾性的,睡眠姿势没有得到客观测量。因此,该联盟指出,不可能前瞻性地研究睡眠姿势与不良妊娠结局之间的关联。我们的目标是证明构建一个基于视觉的模型的可行性,该模型能够在整个孕晚期自动、准确地检测和量化睡眠姿势——该模型的最终目标是进一步开发并被研究人员用作工具,使他们能够证实或反驳上述关联。我们在加拿大范围内对24名孕晚期参与者进行了一项横断面研究。前瞻性收集了11种妊娠特有的模拟睡眠姿势以及有床单和无床单覆盖身体的坐姿的红外视频。我们从48个视频中提取了152,618张图像,对其中5,970张进行了半随机下采样和标注,并将它们输入到一个深度学习算法中,该算法通过六折交叉验证训练并验证了六个模型。使用一个未见过的测试集评估模型的性能。这些模型检测了有床单和无床单覆盖身体的12种姿势,平均精度分别为0.72和0.83,平均召回率(“敏感性”)分别为0.67和0.76。对于有床单和无床单覆盖身体的仰卧姿势类别,模型的平均精度分别为0.61和0.75,平均召回率分别为0.74和0.81。