Conclusion
A computer vision algorithm for prospective measurement of sleeping
position using video under real-world conditions across the third
trimester in the home setting was built and may hold potential to solve
yet unanswered research and clinical questions regarding the
relationship between sleeping position and adverse pregnancy outcomes.
While it is currently unknown whether the association between maternal
supine sleeping position and adverse pregnancy outcomes is causal, it is
certain that there currently exists much controversy regarding the
association
itself.4,21–25The primary source of scepticism is the data underlying this
association, which is based on subjective, self-reported recollection of
sleeping position and does not account for intra-and inter-night
variability in sleeping
position.1,2,4As such, the current study makes a significant stride toward enabling
the study of sleeping positions in the third trimester of pregnancy
using more objective methods that were developed with the unique anatomy
and physiology of pregnancy in mind and can be deployed using ubiquitous
equipment without the need for the researcher to visit the participant’s
home. Using a model like SLeeP AIDePt-2, researchers could automate
measurement of the time spent in each sleeping position across the third
trimester, linking it to pregnancy outcomes. As is standard practice in
machine learning and software applications, SLeeP AIDePt-2 should be
continually audited, iterated, and updated by adding new data to the
dataset and re-training, re-validating, and re-testing the
model.26
For future research, we propose, “The DOSAGE Study: Dose Of Supine
sleep Affects fetal Growth? an Exposure-response Study.” The DOSAGE
Study will be an international, prospective, cohort study aiming at
gathering objective evidence that will either lend support to, or
detract support from, a causal pathway between supine sleeping position
after 28 weeks’ gestation, foetal growth, and late stillbirth, and to
quantify the safe “dose” of nightly supine sleeping time, if any. SeeAppendix C for further details.