Early prediction of low birth weight using boosting ensemble machine learning: A retrospective cohort study

Background Low birth weight (LBW) is a leading cause of death for newborns and increases chronic disease risks later in life. Early identification of LBW risk is crucial. Aim The objective of this study was to develop predictive models for LBW using boosting ensemble machine learning, with a focus on features available during early pregnancy, such as pre-pregnancy body mass index, body height, and blood pressure before 20 weeks of pregnancy. Methods This is a retrospective cohort study. We used electronic medical records in four hospitals in Taiwan where pregnant women received prenatal care from January 2016 to July 2019, including 6719 pregnant women. Data preprocessing involved normalization, one-hot encoding, and a synthetic minority oversampling technique for class imbalance. Boosting ensemble methods were used to build the LBW predictive models. Results The mean diastolic blood pressure (DBP) in early pregnancy (<20 weeks) was 66.5 mmHg, 29.6% had experienced abortion, 8.7% delivered LBW, 12.2% were overweight or obese before pregnancy, and 18.3% had elevated or stage I hypertension before 20 weeks of pregnancy. Lightweight Gradient Boosting Machine was the best-performing LBW model, with an area under curve of 0.96 and an accuracy of 93.4%. Early pregnancy DBP, maternal height, and number of abortions were the most important features. Conclusions The LBW prediction model performed well. Nurses could use the model to assess LBW risk and intervene early. Preventive efforts could be directed to blood pressure management starting early pregnancy, nutritional support for short mothers, and self-care for women with a history of abortions.