Conference PaperPDF Available

Labour probability estimation using a wearable pregnancy monitor: preliminary validation

Authors:

Abstract

Preterm birth (PTB), or birth before the completion of 37 weeks of pregnancy, is the leading cause of neonatal morbidity and mortality and the second-leading cause of death in children under the age of five. The importance of early intervention to prevent and reduce the impact of PTB is clear. However, no solution is currently available to easily allow for early detection of labour. The Bloomlife WISH system is a small wearable pregnancy monitor, worn on a pregnant woman's abdomen, that measures uterine electromyogram (EMG), maternal heart rate and movement, and uses that information to compute a probability of a woman being in labour. Here we report the preliminary validation of the labour probability estimated using this wearable pregnancy monitor.
Labour'probability'estimation'using'a'wearable'pregnancy'
monitor:'preliminary'validation'
!
E.ROSSETTI1,!M.ALTINI1,!M.J.ROOIJAKKERS1,!J.PENDERS1,2,!P.DREESEN3,4,!S.KESSELER5,!
H.MARIËN3,4,!I.M.THIJS3,4,!F.CHANTRAINE5,!W.GYSELAERS4!
!
1!Bloom!Technologies,!Genk,!Belgium!
2!Bloomlife,!San!Francisco,!USA!
3!Hasselt!University,!Faculty!of!Medicine!and!Life!Sciences,!Hasselt,!Belgium;!Limburg!Clinical!
Research!Program!/!Mobile!Health!Unit!
4!Ziekenhuis!Oost-Limburg,!Department!of!Obstetrics!&!Gynecology!and!Department!Future!
Health,!Genk,!Belgium;!Limburg!Clinical!Research!Program!/!Mobile!Health!Unit!
5!Department!of!Obstetrics!&!Gynecology,!CHR!Citadelle,!CHU,!Liège,!Belgium!!!
!
Abstract'Topics:!Preterm!birth!and!prematurity!
!
Introduction'
Preterm!birth!(PTB),!or!birth!before!the!completion!of!37!weeks!of!pregnancy,!is!the!leading!
cause!of!neonatal!morbidity!and!mortality!and!the!second-leading!cause!of!death!in!children!
under!the!age!of!five![1].!The!importance!of!early!intervention!to!prevent!and!reduce!the!
impact!of!PTB!is!clear![2].!However,!no!solution!is!currently!available!to!easily!allow!for!early!
detection!of!labour.!The!Bloomlife!WISH!system!is!a!small!wearable!pregnancy!monitor,!worn!
on!a!pregnant!woman’s!abdomen,!that!measures!uterine!electromyogram!(EMG),!maternal!
heart!rate!and!movement,!and!uses!that!information!to!compute!a!probability!of!a!woman!
being!in!labour.!Here!we!report!the!preliminary!validation!of!the!labour!probability!estimated!
using!this!wearable!pregnancy!monitor.!
!
Material'and'Methods'
A!two-center,!national,!prospective,!interventional!study!(N=150)!was!designed!to!evaluate!the!
accuracy!of!the!Bloomlife!WISH!system!in!detecting!labour.!The!study!was!approved!by!the!
ethics!committees!of!Ziekenhuis!Oost-Limburg!(Genk,!Belgium)!and!CHR!Citadelle!Hospital!
(Liège,!Belgium),!and!by!the!Belgian!Federal!Agency!for!Medicines!and!Health!Products.!After!
consenting!to!participate,!all!study!participants!received!a!Bloomlife!WISH!system,!and!were!
asked!to!use!it!at!least!3!nights!per!week!until!they!deliver.!Follow-up!visits!were!organized!
regularly!to!check!compliance!with!the!protocol,!and!to!collect!clinical!information.!Data!from!
the!Bloomlife!WISH!system!were!collected!during!the!study!visits,!for!later!analysis.!
!
All!recordings!performed!by!the!study!participants!were!analyzed!using!our!labour!detection!
model![3].!The!uterine!EMG,!maternal!heart!rate!and!movement!data!are!processed!to!filter!
artifacts!and!extract!relevant!features!for!labour!detection.!One!feature!set!is!extracted!for!
every!segment!covering!20-min!of!non-artifacted!data.!These!features!are!fed!into!a!linear!
regression!model!that!computes!a!probability!of!the!user!being!in!labour!(labour!probability).!
The!labour!probability!is!a!number!between!0!(very!unlikely!to!be!in!labour)!and!1!(very!likely!to!
be!in!labour).!The!20-min!data!segments!are!labelled!in!two!groups:!labour!and!non-labour,!
depending!on!whether!they!were!recorded!within!24!hour!of!birth!(labour)!or!not!(non-labour).!
Labour!probabilities!for)labour!and!non-labour!segments!are!compared!using!a!Welch!Two!
Sample!t-test!to!for!the!alternative!hypothesis!that!there!is!a!true!difference!in!means!not!equal!
to!0.!!
!
Results'
145!pregnant!women!were!enrolled!in!the!study;!19!participants!dropped!out.!Gestational!age!
at!inclusion!was!27.6!±!2.2!weeks.!67!(53%)!participants!were!nulliparous!and!11!(9%)!
participants!had!a!history!of!preterm!birth.!Gestational!age!at!delivery!was!39.3!±!1.7!weeks.!11!
(9%)!participants!delivered!preterm!(<37!weeks),!35!(28%)!delivered!early!term!(37-38!weeks),!
and!78!(63%)!delivered!at!term!(39+!weeks).!103!(83%)!participants!had!a!vaginal!birth,!40!
(32%)!were!induced,!10!(8%)!had!a!planned!C-section,!and!11!(9%)!had!an!emergency!C-section.!!
!
The!results!are!reported!for!the!first!50!participants!who!delivered.!These!participants!recorded!
a!total!of!7,714!20-min!non-artifacted!data!segments,!including!214!labour!segments!and!7,500!
non-labour!segments.!Probabilities!for!all!segments!are!visualized!in!a!box!plot!that!shows!the!
labour!probability!for!every!segment,!grouped!per!gestational!week.!The!figure!shows!that!
labour!probabilities!for!the!labour!group!are!consistently!higher!than!the!ones!for!the!non-
labour!group,!regardless!of!gestational!age.!Applying!a!Welch!Two!Sample!t-test!to!the!
distributions!of!labour)and!non-labour!recordings!shows!a!statistically!significant!difference!(p-
value!<!0.001)!between!labour!probabilities!of!these!two!groups.!
!
Conclusions'
The!Bloomlife!WISH!system!is!a!small!wearable!pregnancy!monitor!worn!on!a!pregnant!
woman’s!abdomen!that!measures!uterine!EMG,!maternal!heart!rate!and!movement,!and!uses!
that!information!to!compute!a!probability!of!a!woman!being!in!labour.!This!preliminary!analysis!
on!the!first!50!participants!recruited!in!the!study!shows!that!the!labour!probability!computed!
on!labour!data!segments!is!statistically!higher!than!the!labour!probability!computed!on!non-
labour!segments.!Future!work!shall!focus!on!extending!the!validation!to!preterm!births!prior!to!
35!weeks.!!
!
Acknowledgement'
This!project!has!received!funding!from!the!European!Union’s!Horizon!2020!research!and!
innovation!programme!under!grant!agreement!No!778503.!
!
References'
[1]!WHO!–!Recommendations!on!interventions!to!improve!preterm!birth!outcomes!-!
http://apps.who.int/iris/bitstream/handle/10665/183037/9789241508988_eng.pdf!
[2]!ACOG!Committee!on!Practice!Bulletins.!ACOG!Practice!Bulletin.!Clinical!management!
guidelines!for!obstetrician-gynecologist.!Number!43,!May!2003.!Management!of!preterm!labor.!
Obstet!Gynecol.!2003;101:1039-1047.!!
[3]!M.!Altini!et!al,!Early)labour)detection)in)laboratory)and)free-living)conditions)using)combined)
electrohysterography)and)heart)rate)data,!American!Journal!of!Obstetrics!and!Gynecology,!
January!2019,!Volume!220,!Issue!1,!Supplement,!Pages!S513S514!
!
!
!
Figure:)Labour)probabilities)at)different)gestational)ages)for)the)first)50)study)participants.)Light)
grey:)probabilities)for)“labour”)recordings,)defined)as)recordings)within)24)hours)of)birth.)Dark)
grey:)probabilities)for)“non-labour”)recordings.)
!
!
!
!
!
!
ResearchGate has not been able to resolve any citations for this publication.
Clinical management guidelines for obstetrician-gynecologist
ACOG Committee on Practice Bulletins. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologist. Number 43, May 2003. Management of preterm labor. Obstet Gynecol. 2003;101:1039-1047.