Deep learning with information fusion and model interpretation for long-term prenatal fetal heart rate data

Long-term fetal heart rate (FHR) monitoring during the antepartum period, increasingly popularized by electronic FHR monitoring, represents a growing approach in FHR monitoring. This kind of continuous monitoring, in contrast to the short-term one, collects an extended period of fetal heart data. This offers a more comprehensive understanding of fetus’s conditions. However, the interpretation of long-term antenatal fetal heart monitoring is still in its early stages, lacking corresponding clinical standards. Furthermore, the substantial amount of data generated by continuous monitoring imposes a significant burden on clinical work when analyzed manually. To address above challenges, this study develops an automatic analysis system named LARA (Long-term Antepartum Risk Analysis system) for continuous FHR monitoring, combining deep learning and information fusion methods. LARA’s core is a well-established convolutional neural network (CNN) model. It processes long-term FHR data as input and generates a Risk Distribution Map (RDM) and Risk Index (RI) as the analysis results. We evaluate LARA on inner test dataset, the performance metrics are as follows: AUC 0.872, accuracy 0.816, specificity 0.811, sensitivity 0.806, precision 0.271, and F1 score 0.415. In our study, we observe that long-term FHR monitoring data with higher RI is more likely to result in adverse outcomes (p = 0.0021). In conclusion, this study introduces LARA, the first automated analysis system for long-term FHR monitoring, initiating the further explorations into its clinical value in the future.