Premature Birth Clinical Trial
Official title:
Gestational Age Assessment Tool for Newborn Babies
In the UK and worldwide many babies are born without carers knowing their gestation as the
mothers will not have had good antenatal care. It is possible to estimate gestation but this
requires a detailed clinical exam. The investigators wish to improve this by using software
analysis to pick out features of the baby (face and foot) to try and estimate the gestation
of the baby once it is born. The investigators will also look explore if the software can
distinguish the normal face or a baby in discomfort.
Good estimation of gestation can result in more targeted management of the baby. The
investigators will capture the images of newborn babies, from a variety of gestations, and
use this dataset to teach the software to estimate gestational age and level of discomfort.
Clinical techniques for the calculation of gestation include fetal ultrasound and clinical
assessment tools, such as the Ballard Score, following birth. These techniques are rarely
available (ultrasound which is expensive and requires trained users) or require significant
training (Ballard) which makes them unsuitable for large scale assessment in many low-middle
income (LMI) countries. In the UK, the gestational age of babies of mothers with no antenatal
care requires a detailed clinical examination which can lack accuracy. Clinical assessment of
postnatal gestational age utilises anatomical characteristics of the face, ear and foot
during newborn development. There is an element of subjectiveness which reduces the precision
of such an assessment which is only reduced with significant training and experience. Simpler
techniques of postnatal gestational age assessment such as anthropometric measures are time
consuming and lack the accuracy required. Emerging evidence suggests that gestational age can
be calculated postnatally by measuring the newborn foot length and comparing to population
appropriate charts. However, when used on their own, the specificity and sensitivity are
still below acceptable limits to allow universal adoption.
New software-based analytical techniques now make it possible to perform fully automatic
recognition of facial actions and dimensions. The investigators have developed techniques
that allow live video facial feature identification and measurement using advanced analytical
techniques of muscle actions. These techniques have been used for facial expression analysis
as well as automated facial feature localization. The investigators propose that the same
analysis could be used to create a unique gestational age assessment tool using a simple
brief video clip of the newborns' face and foot.
Accurate assessment of gestational age, especially in LMI countries, could ensure high risk
newborns receive appropriate low cost interventions to reduce morbidity and mortality. In the
UK this could allow better estimation of babies born to mothers with no antenatal care where
the gestational age is unclear. We propose a smartphone based, ethnic appropriate, combined
face and foot video analysis tool to accurately determine gestational age of the newborn.
Such a system could adapted to incorporate pain assessment tools to help inform treatment
options and study new therapies.
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