Happy black family

AI project aims to reduce harm among pregnant black women

Image credit: Larry Crayton | Unsplash

Researchers will use artificial intelligence (AI) to analyse maternity investigation reports in the hope of reducing the disproportionate levels of harm among black mothers and babies.

Experts from Loughborough University will work with the Healthcare Safety Investigation Branch (HSIB) to identify patterns in more than 600 of its recent investigations into adverse outcomes during pregnancy and birth.

HSIB, an independent patient safety body, has conducted more than 2,000 maternity investigations since April 2018, with around 10 per cent concerning black, Asian and ethnic minority families. These examined cases such as the death of the mother during pregnancy or childbirth, miscarriages, stillbirths and neonatal deaths.

Black mothers are four times more likely to die from pregnancy complications than white women, according to a report published by MBRRACE-UK earlier this month.

It found that pregnancy is safe, with 8.8 women per 100,000 between 2017-2019 dying either during pregnancy, up to six weeks after childbirth or at the end of pregnancy.

The report noted that outcomes were not equal, with the maternal mortality rates of women from Asian and mixed ethnicity backgrounds around twice as high compared with white women and with an increased risk for women in more deprived areas.

The research team will develop a machine-learning system capable of identifying factors, based on a set of codes, that contribute to harm during pregnancy and birth experienced by black families.

These include biological factors, such as obesity or birth history; social and economic factors, such as language barriers and unemployment; and the quality of care and communication with the mother.

The system will look at how these elements interact with and influence each other, helping researchers design ways to improve the care of black mothers and babies. The researchers believe the findings could also be used to reduce harm among patients of all ethnicities.

They said involving black families in the research is “essential”, with two groups representing patients and the general public who will be consulted throughout “to minimise any potential bias”.

The project is led by Dr Patrick Waterson, from Loughborough University’s human factors and complex systems group in the School of Design and Creative Arts, and Dr Georgina Cosma, an expert in Artificial Intelligence and Data Science from the Department of Computer Science.

Waterson said: “Ultimately, we believe the outcomes from our research have the potential to transform the NHS’s ability to reduce maternal harm among mothers from black ethnic groups. In the longer term, our research could improve patient safety for all mothers, regardless of ethnicity.”

Kevin Stewart, the HSIB’s medical director, said: “We are delighted to be working with Loughborough University to better understand the factors that lead to poor outcomes and experiences for some women from black ethnic groups.

“We believe our data, gathered from so many of our maternity investigations, will help develop the learning required to automate analysis and identification of themes.”

The project will run for two years, starting in January 2022, and is funded by NHSX and the Health Foundation.

Jabeer Butt, chief executive of the Race Equality Foundation, said AI has the potential to improve outcomes if “used wisely”. He said: “A woman’s ethnicity should have no impact on her chances of having a safe and healthy pregnancy, yet the reality for black pregnant women is that it does.

“While we welcome the use of AI to better address the problem through examining key factors, like the care experiences of black mothers, safeguards will be crucial to ensure that the use of AI doesn’t end up exacerbating the inequalities it aims to solve.”

Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, also welcomed the research and said it is exciting to see how AI can progress work in the field.

An AI app developed with the pregnancy charity Tommy’s, which uses routine data from antenatal appointments to assess a woman’s chance of developing complications during pregnancy, is already being piloted in some areas, he said.

Morris added: “More work is urgently needed to understand and end the unequal maternal outcomes that women from black, Asian and minority ethnic groups experience within maternity care.”

Brhmie Balaram, head of AI research and ethics at NHSX, said: “We’re excited to support innovative projects that demonstrate the power of applying AI to address some of our most pressing challenges; in this case, we’re keen to prove that AI can potentially be used to close gaps in minority ethnic health outcomes.

“Artificial intelligence has the potential to revolutionise care for patients and we are committed to ensuring that this potential is realised for all patients by accounting for the health needs of diverse communities.”

Artificial intelligence is establishing a greater presence within the health sector. Last month, an AI model developed by researchers from the University of Oxford and Harvard Medical School demonstrated excellent capability for predicting the implications of human gene variants, identifying them as benign or causes of disease.

In September, cardiologists carried out percutaneous coronary intervention (PCI) heart operations guided by machine-learning software, in a first for NHS Scotland healthcare.

Meanwhile, in Ireland, an AI system that can help to detect breast cancer is being trialled. The tool, which is called Mia (Mammography Intelligent Assessment), helps radiologists to read mammograms by detecting signs of cancer that might otherwise not be noticed.

Earlier this year, the UK government was considering the adoption of an AI-based Covid-19 test designed to detect the virus via recordings of a user coughing into their smartphone’s microphone.

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