IDENTIFICATION OF LATENT RISK CLINICAL ATTRIBUTES FOR CHILDREN BORN UNDER IUGR CONDITION USING MACHINE LEARNING TECHNIQUES

摘要

BACKGROUND AND OBJECTIVE INTRAUTERINE GROWTH RESTRICTION (IUGR) IS A CONDITION IN WHICH A FETUS DOES NOT GROW TO THE EXPECTED WEIGHT DURING PREGNANCY. THERE ARE SEVERAL WELL DOCUMENTED CAUSES IN THE LITERATURE FOR THIS ISSUE, SUCH AS MATERNAL DISORDER, AND GENETIC INFLUENCES. NEVERTHELESS, BESIDES THE RISK DURING PREGNANCY AND LABOUR PERIODS, IN A LONG TERM PERSPECTIVE, THE IMPACT OF IUGR CONDITION DURING THE CHILD DEVELOPMENT IS AN AREA OF RESEARCH ITSELF. THE MAIN OBJECTIVE OF THIS WORK IS TO PROPOSE A MACHINE LEARNING SOLUTION TO IDENTIFY THE MOST SIGNIFICANT FEATURES OF IMPORTANCE BASED ON PHYSIOLOGICAL, CLINICAL OR SOCIOECONOMIC FACTORS CORRELATED WITH PREVIOUS IUGR CONDITION AFTER 10 YEARS OF BIRTH. METHODS IN THIS WORK, 41 IUGR (18 MALE) AND 34 NON-IUGR (22 MALE) CHILDREN WERE FOLLOWED UP 9 YEARS AFTER THE BIRTH, IN AVERAGE (9.1786 ± 0.6784 YEARS OLD). A GROUP OF MACHINE LEARNING ALGORITHMS IS PROPOSED TO CLASSIFY CHILDREN PREVIOUSLY IDENTIFIED AS BORN UNDER IUGR CONDITION BASED ON 24-HOURS MONITORING OF ECG (HOLTER) AND BLOOD PRESSURE (ABPM), AND OTHER CLINICAL AND SOCIOECONOMIC ATTRIBUTES. IN ADDITIONAL, AN ALGORITHM OF RELEVANCE DETERMINATION BASED ON THE CLASSIFIER IS ALSO PROPOSED, TO DETERMINE THE LEVEL OF IMPORTANCE OF THE CONSIDERED FEATURES. RESULTS THE PROPOSED CLASSIFICATION SOLUTION ACHIEVED ACCURACY UP TO 94.73%, AND BETTER PERFORMANCE THAN SEVEN STATE-OF-THE-ART MACHINE LEARNING ALGORITHMS. ALSO, RELEVANT LATENT FACTORS RELATED TO HRV AND BP MONITORING ARE PROPOSED, SUCH AS: DAY-TIME HEART RATE (DAY-TIME HR), DAY-NIGHT SYSTOLIC BLOOD PRESSURE (DAY-NIGHT SBP), 24-HOUR STANDARD DEVIATION (SD) OF SBP, DROPPED, MORNING CORTISOL CREATININE, 24-HOUR MEAN OF SDS OF ALL NN INTERVALS FOR EACH 5 MINUTES SEGMENT (24-HOUR SDNNI), AMONG OTHERS. CONCLUSION WITH OUTSTANDING ACCURACY OF OUR PROPOSED SOLUTIONS, THE CLASSIFICATION SYSTEM AND THE INDICATION OF RELEVANT ATTRIBUTES MAY SUPPORT MEDICAL TEAMS ON THE CLINICAL MONITORING OF IUGR CHILDREN DURING THEIR CHILDHOOD DEVELOPMENT.