Abstract
Objective: To analyze and synthesize the scientific evidence available in the literature on the methods of artificial intelligence (AI) in the early prediction and diagnosis of pregnancy complications. Methods: This is an integrative review, conducted on the EMBASE, PubMed, Scopus, and Web of Science databases, using the following descriptors: “Artificial Intelligence”, “Machine Learning”, “Deep Learning”, “Pregnancy Complications”, “perinatal complications” and “Postpartum”. Studies published between 2019 and 2023 that use AI methods to predict pregnancy complications were included. Results: The final sample consisted of 13 articles, with a higher concentration of publications in the years 2019 and 2020. Most studies were conducted in China, and the predominant research designs were cohort studies. The AI models used were effective in predicting complications such as preeclampsia, gestational diabetes mellitus, premature birth, and placental invasion, using electronic medical records and other biomarkers. Final considerations: This review highlights the significant impact of AI models in improving the prediction and diagnosis of pregnancy complications. The results underline the need for continuous integration of these technologies in obstetric clinical practice, as well as future research to validate and expand their applicability in different clinical contexts.
References
AHMED Z, et al. Artificial Intelligence with Multi-Functional Machine Learning Platform Development for Better Healthcare and Precision Medicine. Database (Oxford). 2020; baaa010.
ARTZI NS, et al. Prediction of Gestational Diabetes Based on Nationwide Electronic Health Records. Nat. Med. 2020; 26(1): 71-76.
BRASIL. Ministério da Saúde (MS). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde, 1998.
CARVALHO DV, et al. Machine Learning Interpretability: A Survey on Methods and Metrics. Electronics. 2019; 8: 832.
CECULA P. Artificial Intelligence: The Current State of Affairs for AI in Pregnancy and Labour. J. Gynecol. Obstet. Hum. Reprod. 2021; 50: 102048.
CERSONSKY TEK, et al. Identifying risk of stillbirth using machine learning. Am J Obstet Gynecol. 2023; 229(3): 327.e1-327.e16.
DHOMBRES F, et al. Contributions of Artificial Intelligence Reported in Obstetrics and Gynecology Journals: Systematic Review. J Med Internet Res. 2022; 24(4): e35465.
EDWARDS P, et al. Obesity in Pregnancy. Obstet. Gynaecol. Reprod. Med. 2020; 30: 315-320.
GAO C, et al. Learning to Identify Severe Maternal Morbidity from Electronic Health Records. Stud. Health Technol. Inform. 2019; 264: 143-147.
GUO Z, et al. Whole‐Genome Promoter Profiling of Plasma DNA Exhibits Diagnostic Value for Placenta‐Origin Pregnancy Complications. Adv. Sci. 2020; 7(7): 1901819.
HO CWL, et al. Governance of Automated Image Analysis and Artificial Intelligence Analytics in Healthcare. Clin. Radiol. 2019; 74: 329-337.
IFTIKHAR PM, et al. Artificial Intelligence: A New Paradigm in Obstetrics and Gynecology Research and Clinical Practice. Cureus, 2020; 12: e7124.
JHEE JH, et al. Prediction Model Development of Late-Onset Preeclampsia Using Machine Learning-Based Methods. PLoS ONE. 2019; 14(8): e0221202.
KHATIBI T, et al. Analysis of Big Data for Prediction of Provider-Initiated Preterm Birth and Spontaneous Premature Deliveries and Ranking the Predictive Features. Arch. Gynecol. Obstet. 2019; 300(6): 1565-1582.
LI YX, et al. Novelelectronic health records applied for prediction of pre-eclampsia: Machine-learning algorithms. Pregnancy Hypertens. 2021; 26:102-109.
LIU M, et al. Development of a prediction model on preeclampsia using machine learning-based method: a retrospective cohort study in China. Front Physiol. 2022; 13: 896969.
MALACOVA E, et al. Stillbirth Risk Prediction Using Machine Learning for a Large Cohort of Births from Western Australia, 1980-2015. Sci. Rep. 2020; 10(1): 5354.
MARIONA FG. Perspectives in Obesity and Pregnancy. Womens Health (Lond). 2016; 12: 523-532.
MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
MENDES KDS, et al. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto Contexto Enferm. 2019; 28: e20170204.
PAPADA SM. Machine learning in medicine: It has arrived, let's embrace it. J Card Surg. 2021; 36(11): 4121-4124.
NGUYEN P, et al. $mathtt {Deepr}$: A Convolutional Net for Medical Records. IEEE J. Biomed. Health Inform. 2017; 21, 22–30.
PEREIRA AS, et al. Metodologia da pesquisa científica. (1ª ed.): UFSM, NTE, 2018.
POON LC, et al. Early prediction of preeclampsia. Obstet Gynecol Int. 2014; 2014: 297397.
RAHMAN A, et al. Impact of Artificial Intelligence (AI) Technology in Healthcare Sector: A Critical Evaluation of Both Sides of the Coin. Clin Pathol. 2024; 17:2632010X241226887.
RAJKOMAR A, et al. Scalable and Accurate Deep Learning with Electronic Health Records. Npj Digital Med. 2018; 1, 18.
RANJBAR A, et al. Machine learning models for predicting preeclampsia: a systematic review. BMC Pregnancy Childbirth. 2024; 24: 6.
RITTENHOUSE KJ, et al. Improving Preterm Newborn Identification in Low-Resource Settings with Machine Learning. PLoS One. 2019; 14(2): e0198919.
SHARMA DD, et al. The Management of Preeclampsia: A Comprehensive Review of Current Practices and Future Directions. Cureus. 2024; 16(1): e51512.
SIRCAR M, et al. Pathogenesis of preeclampsia. Curr Opin Nephrol Hypertens. 2015; 24(2): 131-8.
STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
SUFRIYANA H, et al. Comparison of Multivariable Logistic Regression and Other Machine Learning Algorithms for Prognostic Prediction Studies in Pregnancy Care: Systematic Review and Meta-Analysis. JMIR Med Inform. 2020; 8(11): e16503.
SUN H, et al. Identification of Suspicious Invasive Placentation Based on Clinical MRI Data Using Textural Features and Automated Machine Learning. Eur. Radiol. 2019; 29(11): 6152-6162.
SWEETING AN, et al. A Novel Early Pregnancy Risk Prediction Model for Gestational Diabetes Mellitus. Fetal Diagn Ther. 2019; 45(2): 76-84.
WATANABE M, et al. Prediction of gestational diabetes mellitus using machine learning from birth cohort data of the Japan Environment and Children's Study. Sci Rep. 2023; 13(1): 17419.
WHITTEMORE R, et al. The integrative review: updated methodology. J Adv Nurs. 2005; 52(5):546-53.
WORLD HEALTH ORGANIZATION (WHO). WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization; 2018.
WORLD HEALTH ORGANIZATION (WHO). Trends in Maternal Mortality: 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2019. Geneva: World Health Organization. WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
ZHANG H, et al. Integration of clinical demographics and routine laboratory analysis parameters for early prediction of gestational diabetes mellitus in the Chinese population. Front Endocrinol (Lausanne). 2023; 14:1216832.
