Grđan Stevanović Petra, Barišić Nina, Šunić Iva, Malby Schoos Ann-Marie, Bunoza Branka, Grizelj Ruža, Bogdanić Ana, Jovanović Ivan, Lovrić Mario
Department of Pediatrics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia.
School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
J Pers Med. 2024 Aug 30;14(9):922. doi: 10.3390/jpm14090922.
The aim of this study was to understand how neurological development of preterm infants can be predicted at earlier stages and explore the possibility of applying personalized approaches.
Our study included a cohort of 64 preterm infants, between 24 and 34 weeks of gestation. Linear and nonlinear models were used to evaluate feature predictability to Bayley outcomes at the corrected age of 2 years. The outcomes were classified into motor, language, cognitive, and socio-emotional categories. Pediatricians' opinions about the predictability of the same features were compared with machine learning.
According to our linear analysis sepsis, brain MRI findings and Apgar score at 5th minute were predictive for cognitive, Amiel-Tison neurological assessment at 12 months of corrected age for motor, while sepsis was predictive for socio-emotional outcome. None of the features were predictive for language outcome. Based on the machine learning analysis, sepsis was the key predictor for cognitive and motor outcome. For language outcome, gestational age, duration of hospitalization, and Apgar score at 5th minute were predictive, while for socio-emotional, gestational age, sepsis, and duration of hospitalization were predictive. Pediatricians' opinions were that cardiopulmonary resuscitation is the key predictor for cognitive, motor, and socio-emotional, but gestational age for language outcome.
The application of machine learning in predicting neurodevelopmental outcomes of preterm infants represents a significant advancement in neonatal care. The integration of machine learning models with clinical workflows requires ongoing education and collaboration between data scientists and healthcare professionals to ensure the models' practical applicability and interpretability.
本研究的目的是了解如何在更早阶段预测早产儿的神经发育,并探索应用个性化方法的可能性。
我们的研究纳入了64名孕周在24至34周之间的早产儿队列。使用线性和非线性模型评估在2岁校正年龄时特征对贝利量表结果的预测能力。结果分为运动、语言、认知和社会情感类别。将儿科医生对相同特征预测能力的看法与机器学习进行比较。
根据我们的线性分析,败血症、脑磁共振成像结果和5分钟时的阿氏评分对认知有预测作用,校正年龄12个月时的阿米尔 - 蒂松神经学评估对运动有预测作用,而败血症对社会情感结果有预测作用。没有任何特征对语言结果有预测作用。基于机器学习分析,败血症是认知和运动结果的关键预测因素。对于语言结果,孕周、住院时间和5分钟时的阿氏评分有预测作用,而对于社会情感结果,孕周、败血症和住院时间有预测作用。儿科医生的看法是,心肺复苏是认知、运动和社会情感的关键预测因素,但孕周对语言结果有预测作用。
机器学习在预测早产儿神经发育结局中的应用代表了新生儿护理领域的一项重大进展。将机器学习模型与临床工作流程相结合需要数据科学家和医疗保健专业人员之间持续的教育和合作,以确保模型的实际适用性和可解释性。