Prediction of neonatal deaths in NICUs: development and validation of machine learning models

Background: Prediction of neonatal deaths in NICUs is important for benchmarking and evaluating healthcare services in NICUs. Application of machine learning techniques can improve physicians� ability to predict the neonatal deaths. The aim of this study was to present a neonatal death risk prediction model using machine learning techniques. Methods: This study was conducted in Tehran, Iran in two phases. Initially, important risk factors in neonatal death were identified and then several machine learning models including Artificial Neural Network (ANN), decision tree (Random Forest (RF), C5.0 and CHART tree), Support Vector Machine (SVM), Bayesian Network and Ensemble models were developed. Finally, we prospectively applied these models to predict neonatal death in a NICU and followed up the neonates to compare the outcomes of these neonates with real outcomes. Results: 17 factors were considered important in neonatal mortality prediction. The highest Area Under the Curve (AUC) was achieved for the SVM and Ensemble models with 0.98. The best precision and specificity were 0.98 and 0.94, respectively for the RF model. The highest accuracy, sensitivity and F-score were achieved for the SVM model with 0.94, 0.95 and 0.96, respectively. The best performance of models in prospective evaluation was for the ANN, C5.0 and CHAID tree models. Conclusion: Using the developed machine learning models can help physicians predict the neonatal deaths in NICUs. © 2021, The Author(s)

A case report of complete resolution of nonimmunological hydrops fetalis without known etiology

The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80 mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with preterm birth at this age due to preterm uterine contractions. No etiology was found for hydrops and all signs resolved thoroughly after birth without treatment. After birth, the newborn was admitted to neonatal intensive care unit and discharged after 47 days in good condition. The infant was completely healthy within three months after delivery. © 2021