Development of prognostic model for preterm birth using machine learning in a population-based cohort of Western Australia births between 1980 and 2015

Abstract

Preterm birth is a global public health problem with a signifcant burden on the individuals afected. The study aimed to extend current research on preterm birth prognostic model development by developing and internally validating models using machine learning classifcation algorithms and population-based routinely collected data in Western Australia. The longitudinal retrospective cohort study involved all births in Western Australia between 1980 and 2015, and the analytic sample contains 81,974 (8.6%) preterm births (< 37 weeks of gestation). Prediction models for preterm birth were developed using regularised logistic regression, decision trees, Random Forests, extreme gradient boosting, and multi-layer perceptron (MLP). Predictors included maternal sociodemographics and medical conditions, current and past pregnancy complications, and family history. Class weight was applied to handle imbalanced outcomes and stratifed tenfold cross-validation was used to reduce overftting. Close to half of the preterm births (49.1% at 5% FPR, 95% CI 48.9%,49.5%) were correctly classifed by the best performing classifer (MLP) for all women when current pregnancy information was available. The sensitivity was boosted to 52.7% (95% CI 52.1%,53.3%) after including past obstetric history in a sub-population of births from multiparous women. Around half of the preterm birth can be identified antenatally at high specificity using population-based routinely collected maternal and pregnancy data. The performance of the prediction models depends on the available predictor pool that is individual and time speciifc.