The journey of pregnancy is truly remarkable and life-changing for soon-to-be parents and their families. The anticipation and expectation of starting a family can be daunting. However, with the right medical care and consultation, families can look forward to having a healthy and flourishing generation to come. One of the key concerns that parents have is the monitoring of fetal growth throughout the nine months of pregnancy.
With the current lifestyle trends, we often hear cases of newborn babies being delivered under critical circumstances. One such circumstance is known as Small-for-Gestational-Age or SGA. SGA is defined as babies with a birth weight of less than the 10th percentile for gestational age. In short, the baby is born severely underweight. SGA babies can be a result of Fetal Growth Restrictions (FGR), where the growing fetus is unable to achieve its ideal individual growth potential due to several factors.
The physical comparison between an SGA baby and a healthy baby
SGA babies with FGR face a greater risk of health complications in addition to increased risks of developing chronic medical diseases in the late stages of life. Affecting 10-15% of pregnancies globally, FGR babies pose significant concerns and challenges in obstetrics management. For instance, babies with FGR have a fivefold increased risk of perinatal death compared to those with normal growth. Undetected complications during pregnancy can have dire consequences. Hypertensive disorders of pregnancy, such as preeclampsia, affect about 5-8% of all pregnancies and can lead to severe maternal and fetal complications if not identified and managed timely.
Preterm birth, affecting about 10% of pregnancies, is another significant risk, often leading to long-term health problems for the child. Furthermore, undetected or untreated FGR can lead to severe complications such as preterm birth, neonatal intensive care unit (NICU) admission, and long-term developmental issues.
Dr. Saw Shier Nee is a Senior Lecturer at the Department of Artificial Intelligence at the Faculty of Computer Science and Information Technology. Her expertise encompasses Biomedical Engineering in Biomechanics and Artificial Intelligence Diagnostic Technique in Healthcare.
Dr. Saw is currently researching Neoguard, a solution to improve the current methods of diagnosing FGR and monitoring fetal growth status throughout pregnancy using an interactive dashboard that brings ease and clarity in tracking fetal growth, offering consistent, automated comparison against recognised growth chart benchmarks and early detecting of SGA using AI. Early detection of SGA and proper clinical management are crucial in mitigating these risks and ensuring healthier outcomes for both the mother and the baby.
Display of the Neoguard’s interactive dashboard
This conventional way of tracking fetal growth during pregnancy using an international growth chart is inaccurate, leading to current clinical diagnosis accuracy and sensitivity at 57% and 23%, respectively. The implementation of the Neoguard technology allows doctors and mothers to have proper diagnoses and insights into the development of the fetus.
There are two features of Neoguard technology. The first is the interactive growth chart, where the growth trajectory of the fetus can be tracked and analysed in detail using our local Malaysia population growth chart, which reflects our population’s characteristics better and provides a more accurate assessment of fetal growth. The second benefit is using AI technology, which forecasts the baby’s outcome at birth and enables early detection of SGA. Additionally, Neoguard can be implemented as early as week 14 (second trimester) of the pregnancy as compared to current clinical practices, where the majority of SGA takes place in the third trimester.
The comparison between Clinical Diagnosis with Neoguard
When asked if Neoguard has the capacity and support to analyse the fetal growth of more than one fetus at a time, Dr. Saw mentioned that the current development of Neoguard is focused on singleton pregnancy and has not been expanded to cater to more than one fetus in the womb.
Dr. Saw’s research on Neoguard leverages on extensive data from the University Malaya Medical Centre, comprising around 5,500 patient data.
With over 140,000 antenatal and 20,000 postnatal records containing fetal biometric measurements and maternal data, Dr. Saw believes that Neoguard’s technology using a novel AI model that performs early prediction of a baby being born SGA using fetal ultrasound measurements and maternal information, is the next step forward in ensuring a healthy pregnancy and delivery process.
She further believes that with the intervention of Neoguard, the entire process assures mothers of their baby's well-being throughout pregnancy and supports clinicians' decision-making to mitigate adverse outcomes such as preterm birth and stillbirth with sufficient data and analysis.
This research would not have been possible without Dr. Saw’s team of clinicians from Universiti Malaya - Prof. Dr. Loo Chu Kiong from the Department of AI, Faculty of Computer Science and Information Technology, Assoc. Prof. Dr. Azanna Ahmad Kamar from the Department of Pediatrics, Assoc. Prof. Dr. Sofiah Sulaiman, Dr. Rahmah Saaid, and Dr Neha Sethi Naresh Sethi from the Department of Obstetric and Gynaecology, Faculty of Medicine.
Dr. Saw also has a team of students working alongside her through the development of this research - Yang Sze Jue, Darren Sow Zhu Jian, and Cheong Yi Fong.
With the Malaysian population forecasted to reach 34.3 million by 2025 with around 500,000 births, Neoguard has the potential to aid and analyse the growth of fetuses for the next generation and beyond. As Neoguard is in its initial stages, awareness of Neoguard must be recognised by clinicians, medical practitioners, and the Malaysian government to ensure that Neoguard is an accessible technology for mothers and babies of all walks of life.
With the Malaysia Madani budget of RM 41.22 billion for the health ministry and RM 150 million for ICT, Neoguard plays a pivotal role in revolutionising fetal growth monitoring and SGA prediction.
Researchers featured:
Dr. Saw Shier Nee
Department of Artificial Intelligence,
Faculty of Computer Science and Information Technology, UM
For inquiries, please contact: sawsn@um.edu.my
or 03-79676341
Author:
Ms Rajeshi R Cumaravadivale
A Masters student pursuing English Language Studies with past marketing experience in the working field, I am very passionate about writing and telling stories that matter. In my free time, I love to read and write book reviews, learn new languages, and spend time doing Paint By Numbers canvases
Copyedit:
Siti Farhana Bajunid Shakeeb Arsalaan Bajunid, Assistant Registrar, UM
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