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.