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THE APPLICATION OF RADIAL BASIS FUNCTIONS AND SUPPORT

VECTOR MACHINES TO THE FOETAL WEIGHT PREDICTION

FERNANDO SERENO JOAQUIM P. MARQUES DE SÁ

FEUP – Faculdade de Engenharia da FEUP – Faculdade de Engenharia da
Universidade do Porto and INEB - Universidade do Porto and INEB -
Instituto de Engenharia Biomédica, Instituto de Engenharia Biomédica,
Porto, Portugal (fsereno@fe.up.pt) Porto, Portugal

ANA MATOS JOÃO BERNARDES

HSJ – Hospital de S. João, Dep. FMUP – Faculdade de Medicina da
Ginecologia e Obstectrícia, Porto, Universidade do Porto and INEB -
Portugal Instituto de Engenharia Biomédica,
Porto, Portugal

ABSTRACT
Foetal weight prediction based on echographic features is an important
procedure in perinatal medicine. Classical methods of foetal weight prediction
have serious shortcomings in current clinical practice. We investigated the
application of Radial Basis Functions (RBF) and Support Vectors Machines
(SVM) neural networks in order to predict foetal weights in a reliable way. A
RBF was trained using a set of 220 input vectors of echographic features
spanning a foetal weight range from 1500 to 4500 grams and was tested in a
separate set of 55 cases with similar distribution. The overall absolute relative
error attained a reasonable 6.2%. However, for foetal weights greater than 4000
grams the relative error was of the order of minus 10%, underestimating foetal
weights, a problem we tried to solve using a SVM classifier. Keywords:
Artificial Neural Networks, Pattern Recognition, Bio-Medical Engineering
Applications, Prediction, Radial Basis Functions, RBF, Support Vector
Machines, SVM.

INTRODUCTION
Pre-natal foetal weight prediction is an important part of obstetric and
neonatal management, since foetuses who have not grown properly may have a
higher perinatal mortality rate and are namely at high risk for neurological
problems.
Traditional formulas to estimate the foetal weight take at least two
echographic measurements: the abdominal circumference (AC) and the femur
length (FL) or the biparietal diameter (BPD). These formulas were derived from
linear generalized models by Hadlock and Shepard (Farmer et al., 1992).
The need for a quick and easy method for estimating foetal weight has been
clearly established. Results of a statistical analysis and multiple multivariable
linear regressions showed that: (i) the birth weight is a logarithmic function of
foetal body parameters and that the abdominal circumference has the single best
correlation with the log10 of the birth weight; (ii) linear regression with the use
of two foetal dimensions (abdominal circumference and biparietal diameter) had
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a standard deviation of 106 grams per kilogram foetal weight (Warsof et al.,
1977).
Farmer et al. (1992) used a neural network model for the ultrasonic
estimation of foetal weight in the macrosomic foetus and obtained an average
error of 4.7% from actual birth weight, statistically better (p=0.001) than the
results obtained from regression models.
Chauhan et al. (1998) compared the accuracies of ultrasonographic
estimates of birth weights among infants born between 24 and 34 weeks of
gestation at three tertiary centers and concluded that “ultrasonographic estimates
for preterm infants, as obtained from 26 equations are characterized by a rather
wide range of accuracy, [and] for most of the equations the accuracies of
estimates differ markedly among centers.”
The objective of the present prospective study is to investigate the
application of Radial Basis Functions (RBF) and Support Vector Machines
(SVM) neural networks in order to predict foetal weights.

METHODS AND DATA

Echographic features taken on 414 pregnant voluntary women, within 7
days before birth, were collected by obstetricians in four Portuguese hospitals
during 1998-2000. A mean gestational age at delivery of 39 (± 2) weeks was
reported originating data that seems to be representative of the population in
study. The frequencies in the birth weight categories 3000-3499 g (grams) and
3500-3999 g are bigger than other categories. Table 1 represents the birth weight
frequency distribution and Table 2 depicts summary statistics of echographic
measurements taken from the foetus, within 7 days before labour, and at birth
measurements of weight, length and cephalic circumference.
We selected 275 cases as appropriate for neural network training by
eliminating example patterns deteriorated by missing data, outliers, erroneous or
inconsistent data. We used a RBF algorithm for supervised learning of an
approximation function over the foetal weight range 1500-4500 grams, and a
SVM algorithm for supervised learning classification in the two-category of
foetal weights 3500-4000g and greater than 4000g, and evaluated the
performance by the sensitivity, specificity and overall accuracy.

Birth Weight 1500- 2000- 2500- 3000- 3500-

< 1500 > 4000
1999 2499 2999 3499 3999
Frequency % 1.9 3.4 4.1 17.9 39.6 24.9 8.2
Table 1. Frequency distribution of 414 Portuguese birth weights

Our verification of the accuracy and appropriateness of the echographic

measurements for training neural networks, as is suggested by Hudson &
Cohen_(2000; p.122), made necessary cases exclusion.

APPROPRIATENESS OF RBF ALGORITHM AND PERFORMANCE

EVALUATION
We used an RBF algorithm, developed by Bishop (1997) & Nabney (1999)
for use within the MATLAB Neural Networks Tools (Hagan et al., 1996), that
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uses a combination of unsupervised learning in a hidden layer, and a supervised

learning technique in the output layer, schematically represented in Table 3, as a
variant of Hudson & Cohen (2000; p.42) using the EM algorithm for the inputs
to hidden layer weights determination (McLachlan & Krishnan,1997).

Mean Stand. Dev. Units

Biparietal Diameter (BPD) 9.20 0.6 cm
Echographic Cephalic Circumference (CC) 32.8 1.8 cm
Measurements Abdominal Circumference (AC) 33.1 3.1 cm
Femur Length (FL) 7.1 0.5 cm
Umbilical Artery Resistance Index (URI) 0.6 0.1
Birth Weight 3,225 628 g
Measurements
Length 48.6 2.9 cm
Cephalic Circumference 34.3 2.0 cm
Table 2. Descriptive statistics of 414 Portuguese infants

To improve performance we used pre-processing to reduce noise and

inconsistent data: (i) the input space consisted of only four echographic
measurements as far as our prior knowledge about fetal weight association and
umbilical resistence index (URI) was uncertain; (ii) we filtered cases that were
not in the neighbourhood of the centres of each category of foetal weights. Each
case was characterised by a vector of three normalised features, AC, BPD and
FL. The centre of each category was defined by a vector whose components
were the averages of these normalised features of all cases belonging to the
category. If in a given category a case had a distance to this centre greater than
1,5 standard deviations, then it was excluded.
The RBF NNs had a hidden layer with 10 units and Gaussian basis
functions, were trained by 220 cases and tested in a separated set of 55 cases,
and gave the results that are summarised in the Table 5.

Radial Basis Function (RBF) Algorithm

Assign Connections Weights
• Output layer weights assigned to small random numbers
Initialise
For the hidden layer
• Use a small number of iterations of the k-means algorithm;
• Determine hidden layer centres by fitting a Gaussian mixture model with circular co-
variances using the EM algorithm;
• Set Gaussian activation functions widths to the maximum inter-centre squared distance.
Iterate until convergence
For the output layer
• wij(t+1) = wij(t) + ∆wij
where
• ∆wij = η δi µ j
where η is the learning rate, and
• δi = Ti - µ i
where Ti is the target output activation and µ i is the actual output activation at unit i.
Repeat until convergence
Table 3
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USING SVM TO PREDICT HIGH FOETAL WEIGHTS

Support Vector Machines (SVM) have been successfully applied to a
number of classification and regression tasks, similar to the foetal weight
prediction (Odone et al., 1998; Veropoulos et al., 1999). The SVM algorithm is
based on the theory of finite sample statistics, which shows that the critical
quantity is not the number of parameters in the system, but the Vapnik-
Chervonenkis (Vapnik, 1995) dimension of the set of functions available to the
system.
Since its introduction the SVM theory has been developing and gaining
popularity due to many attractive features and promising empirical performance.
A detailed explanation of SVM would be beyond the scope of this paper, and
can be found, for example, in Cristianiani (2000) or Haykin (1999; pp. 318-350).
We used an SVC algorithm developed by Gunn (1998) for use within the
MATLAB Neural Networks Tools. The main steps in the algorithm are
summarised in the Table 4.

The SVC algorithm

• Construct the kernel matrix
• Add a small amount of zero order regularization to avoid problems when Hessian is badly
conditioned
• Initialize optimization parameters
• Solve the optimization problem by quadratic programming
• Compute de number of Support Vectors

Table 4

SVC classifiers were trained by a set T = {x i , d }iN=1 , where N = 72 inputs

vectors, xi consisting of two echographic features, the abdominal circumference
(AC) and another echographic measurement, FL, BPD, CC or URI. The target d
is -1 if the corresponding foetal weight category is greater than 4000, and +1
otherwise. We experimented, among several possible kernels, an order 20 spline
kernel matrix, and used in the Lagrangian a related regularization parameter C
equal to 105 for optimisation and selection of the support vectors. The SVC
classifiers were tested by a set with the number of cases N=37, separate from the
learning one, and whose input vectors xi have the same subset of echographic
features. SVM classifiers performance is summarised in Table 5.

CONCLUSIONS
Whereas the foetal weight relative absolute error using Hadlock and
Shepard formulas were 7.8% and 7.5%, respectively, using RBF NN we got the
lowest relative absolute error, 6.2 %, as can be seen in Table 5.
The sensitivities, specificities and accuracies provided in Table 5 were
estimated for five 500 g foetal weight classes in order to give a detailed picture
of the statistical validity of neural nets regarding birth weight prediction. This
clearly underestimates the clinical validity, which would improve if calculated
for the more relevant clinical classes of foetal weights higher or inferior to 3500
g and 1500 g, respectively.
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RBF PREDICTED FETAL WEIGHT

4500

4000
•-Real o - Predicted

3500

3000

2500

2000

1500
0 10 20 30 40 50
# CASE

Fig. 1 Graphical representation of 55 real and estimated weights by an RBF with ten hidden
Gaussian units and one output linear unit. Shows the real foetal weights ordered increasingly and
represented by dots, and the corresponding estimated foetal weights represented by circles.

Estimation Classification
Model Inputs Error Sensitivity Specificity Accuracy
Hadlock AC, FL 0.078 0.60 0.52 0.55
Shepard AC, BPD 0.075 0.60 0.55 0.56
AC, FL 0.076 0.73 0.61 0.64
AC, BPD 0.067 0.64 0.60 0.57
RBF Estimation and

(1000-4500 g)
Classification

AC, FL, BPD 0.062 0.69 0.53 0.61

AC, FL, BPD, CC 0.067 0.75 0.58 0.69

AC, FL, BPD, CC, URI 0.068 0.74 0.74 0.60

AC, FL N.A. 0.78 0.45 0.70
(3500-4500 g)
Classification

AC, BPD N.A. 0.85 0.45 0.86

SVM

AC, CC N.A. 0.85 0.27 0.68

AC, URI N.A. 0.81 0.27 0.65

Table 5 Estimation and classification Errors.

AC – Abdominal Circumference. BPD – Biparietal Diameter. CC – Cephalic Circumference. FL –
Femur Length. URI – Umbilical Resistance Index. RBF – Radial Basis Function. SVM – Support
Vector Machine (Classifier). N.A. - Not Appropriate.
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RBF neural nets performance gave in these experiments lower error ratios
than multi-layer perceptron (MLP) solutions that we have experimented with a
different training set and reported previously in Sereno et al. (2000).
Nevertheless, as can be seen in Fig. 1, the RBF prediction sub-estimates the
larger foetal weights, probably because this range is poorly represented in the
data available. The RBF NN trained with 1000-4500 grams patterns may
become biased either by the higher frequency of the mean foetal weights, or by
noise that may be present in the big foetal weights range. Therefore, in this
range, the false negatives could be an influence to a wrong prediction of the risk
of emergency Cesarian section for a pregnant woman.
We are currently improving the generalization performance of an RBF-
SVM-heuristic rules approach by re-scaling the input variables in proportion to
their relative importance in the output, using prior knowledge in training
strategies applied to RBF and SVM function approximation architectures, and
reducing the variance by combining the outputs of MLP, RBF, SVM and
knowledge-based artificial NN (Mitchell, 1997) to form committees that could
effectively improve the accuracy of the foetal weight approximation.

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