Introduction
The supine going-to-sleep position, when adopted after 28 weeks of
pregnancy, is associated with giving birth to a
small-for-gestational-age infant and late
stillbirth.1,2While some professional associations, including the Royal College of
Obstetricians and Gynaecologists, have incorporated this evidence into
clinical practice
guidelines,3the National Institute for Health and Care Excellence has pointed out
that the evidence underlying this association is based on retrospective
studies of self-reported going-to-sleep position, which may be limited
by inaccuracies and recall
bias4and does not account for the variability in sleeping position following
sleep onset. As such, the potential impact of sleeping position from 28
weeks through birth on pregnancy outcomes has not yet been prospectively
verified with objective measurements.
We previously built a computer vision model (“SLeeP AIDePt-1”; Sleep
in Late Pregnancy: Artificial Intelligence for the Detection of
Position) to automatically detect sleeping positions during pregnancy
from video recordings. This model was built using a video dataset
captured from pregnant individuals in their third trimester simulating a
range of sleeping positions in a controlled
setting.5However, real-world generalizability and ecological validity was
severely limited because the video dataset only contained a single
person in the bed, used thin and pattern-free bed sheets, did not allow
any objects on the bed besides head pillows, did not include prone
posture, and, overall, did not capture the complexities of real-world
scenarios.
In an attempt to transition to real-world settings (the present study),
our objective was to expand our controlled-setting dataset to include
real-world videos and develop a new model (“SLeeP AIDePt-2”) for
automated, unobtrusive, and non-contact detection and measurement of the
sleeping position of a pregnant individual and their bed partner
simultaneously overnight throughout the third trimester in the home
setting. We aim to equip researchers with a tool employing this model to
enable them to either confirm or disprove the associations between
supine sleeping position in late pregnancy and adverse outcomes.