Current State of Artificial Intelligence Model Development in Obstetrics

Publications on artificial intelligence (AI) applications have dramatically increased for most medical specialties, including obstetrics. Here, we review the most recent pertinent publications on AI programs in obstetrics, describe trends in AI applications for specific obstetric problems, and assess AI's possible effects on obstetric care. Searches were performed in PubMed (MeSH), MEDLINE, Ovid, ClinicalTrials.gov , Google Scholar, and Web of Science using a combination of keywords and text words related to "obstetrics," "pregnancy," "artificial intelligence," "machine learning," "deep learning," and "neural networks," for articles published between June 1, 2019, and May 31, 2024. A total of 1,768 articles met at least one search criterion. After eliminating reviews, duplicates, retractions, inactive research protocols, unspecified AI programs, and non-English-language articles, 207 publications remained for further review. Most studies were conducted outside of the United States, were published in nonobstetric journals, and focused on risk prediction. Study population sizes ranged widely from 10 to 953,909, and model performance abilities also varied widely. Evidence quality was assessed by the description of model construction, predictive accuracy, and whether validation had been performed. Most studies had patient groups differing considerably from U.S. populations, rendering their generalizability to U.S. patients uncertain. Artificial intelligence ultrasound applications focused on imaging issues are those most likely to influence current obstetric care. Other promising AI models include early risk screening for spontaneous preterm birth, preeclampsia, and gestational diabetes mellitus. The rate at which AI studies are being performed virtually guarantees that numerous applications will eventually be introduced into future U.S. obstetric practice. Very few of the models have been deployed in obstetric practice, and more high-quality studies are needed with high predictive accuracy and generalizability. Assuming these conditions are met, there will be an urgent need to educate medical students, postgraduate trainees and practicing physicians to understand how to effectively and safely implement this technology.