Intelligent system based on data mining techniques for prediction of preterm birth for women with cervical cerclage

Preterm birth, defined as a delivery before 37 weeks' gestation, continues to affect 8-15% of all pregnancies and is associated with significant neonatal morbidity and mortality. Effective prediction of timing of delivery among women identified to be at significant risk for preterm birth would allow proper implementation of prophylactic therapeutic interventions. This paper aims first to develop a model that acts as a decision support system for pregnant women at high risk of delivering prematurely before having cervical cerclage. The model will predict whether the pregnancy will continue beyond 26 weeks' gestation and the potential value of adding the cerclage in prolonging the pregnancy. The second aim is to develop a model that predicts the timing of spontaneous delivery in this high risk cohort after cerclage. The model will help treating physicians to define the chronology of management in relation to the risk of preterm birth, reducing the neonatal complications associated with it. Data from 274 pregnancies managed with cervical cerclage were included. 29 of the procedures involved multiple pregnancies. To build the first model, a data balancing technique called SMOTE was applied to overcome the problem of highly imbalanced class distribution in the dataset. After that, four classification models, namely Decision Tree, Random Forest, K-Nearest Neighbors (K-NN), and Neural Network (NN) were used to build the prediction model. The results showed that Random Forest classifier gave the best results in terms of G-mean and sensitivity with values of 0.96 and 1.00, respectively. These results were achieved at an oversampling ratio of 200%. For the second prediction model, five classification models were used to predict the time of spontaneous delivery; linear regression, Gaussian process, Random Forest, K-star, and LWL classifier. The Random Forest classifier performed best, with 0.752 correlation value. In conclusion, computational models can be developed to predict the need for cerclage and the gestation of delivery after this procedure. These models have moderate/high sensitivity for clinical application.