The importance of sleep for improving brain function, mood, cardiovascular health, metabolic health and staving off dementia has emerged as a hot topic, but for pregnant women, sleep position may also prove critical for giving birth to a healthy child.

Although there is a known association between back sleeping after 28 weeks of pregnancy and low-weight infants and stillbirth, the casual proof is difficult to ascertain, and some experts doubt the connection altogether. However, 91亚色鈥檚 and team have developed a computer vision tool that can identify various sleep postures during pregnancy and potentially lead to more definitive answers in the future.

An assistant professor in 91亚色鈥檚 School of Health Policy and Management, Faculty of Health, and a member of 91亚色鈥檚 Centre for AI and Society and Connected Minds, Dolatabadi is interested in developing artificial intelligence and machine learning solutions to health issues. She spent much of her early years developing sensing technologies, also called ambient intelligence, and was in search of a real-world issue when her former student Allan Kember of the University of Toronto, now an obstetrician/gynecologist at Mount Sinai Hospital, suggested maternal sleeping posture.

鈥淭hese types of technologies that I鈥檝e worked on can be embedded in the environment and the maternal sleeping posture and poor infant outcomes is a modifiable risk factor,鈥� she says.

Along with the Vector Institute, where she was formerly an applied scientist and health lead, Dolatabadi and team have come out with the second version of an AI tool designed to monitor the sleeping positions of pregnant women throughout the night.

鈥淲e've developed a vision-based tool that automatically detects the sleep postures of pregnant women using video recordings. This tool is part of a larger initiative aimed at creating unobtrusive and affordable health sensing technologies,鈥� says Dolatabadi. 鈥淲hat鈥檚 remarkable is that the tool can accurately detect common sleep postures, such as side and back sleeping, even in real-world settings with blankets, pillows, and more than one person in bed.鈥�

The research team used video from an observational, four-night, home sleep apnea study with 15pregnant participants and 13 bed partners along with controlled-setting video recordings from a previous in-home, simulation study where 26 participants simulated a series of 12 pre-defined body postures. Pregnant participants were between 28- and 40-weeks gestation from across Canada.

The data was combined and used to train and test the tool, which was able to detect 13 pre-defined sleeping positions, including sitting. Although it did better at , it learned to distinguish the anatomy and physiology of a pregnant person compared to their non-pregnant partner 鈥� or, in one case, the pets which were also in the bed 鈥� as well as pelvis position, says Dolatabadi, adding these were some of the complexities involved in training the AI tool.

Sleep positions included supine pelvis with left or right thorax tilts, supine thorax with right or left pelvic tilts, and prone. It was also able to detect pillows and blankets.

In real-world applications, the tool will allow for the study of pregnant women in a natural setting, providing more, higher quality and more accurate information than is currently available as it won鈥檛 be relying on self reports and someone鈥檚 memory of their sleeping position.

As Dolatabadi says, 鈥淭his technology has the potential to answer how sleep positions may affect pregnancy outcomes, including factors like baby size and stillbirth risk, and solve the controversy and uncertainty about the association between the supine sleeping posture and outcomes.鈥�

In the future, the team plans to refine the tool with plans to make it multi-modal. This would involve training it to monitor and predict heart rate and other vitals using just a camera or phone. It is possible to predict things like heart rate using vision tools without the need for more invasive monitoring sensors, she says.

This would not only provide more robust data to assess the risk of sleep position but also to predict the risk of sleep apnea without people having to go to a sleep clinic.

鈥淭he more we can infuse into the model, the better outcome that we can get,鈥� says Dolatabadi.

Going forward, Dolatabadi is interested in further evaluating generative AI to ensure models are not propagating or creating inequities in health-care environments.

鈥淚t鈥檚 important to evaluate health AI applications as they are susceptible to biases and harm, whether it鈥檚 medical diagnostics or administrative billing for hospital services. There are models of this nature that have been integrated into health-care workflow in U.S. hospitals and it's been shown that they have created some unintended inequities for some patient groups,鈥� says Dolatabadi.

鈥淓mbedded biases in health-care practices, reflected in the data used for model training, algorithmic decision-making, and the extent to which social determinants of health are considered in model design, can lead to unintended harm and exacerbate existing disparities. As health-care settings increasingly adopt these powerful AI models, now is the time to ensure they are responsible.鈥�

The paper, , was published in Scientific Reports.

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Researchers say healthy thyroid functioning is crucial for fetal brain development and their latest research may explain earlier findings looking at fluoride and children鈥檚 IQ

TORONTO, Feb. 09, 2023 鈥�  found that fluoride exposure via drinking water may increase the risk of hypothyroidism in pregnant women. In a smaller subset of participants, the researchers found lower IQ scores between boys whose mothers had been diagnosed with hypothyroidism compared to boys whose mothers had normal thyroid levels.

Earlier research done by the same lab at 91亚色 found an association between maternal fluoride exposure in pregnancy and lower IQ in boys, and this new research may explain these earlier findings, according to 91亚色 neuropsychology PhD student Meaghan Hall, lead author of this latest study.

鈥淲e know from the literature that there is a link between high levels of fluoride exposure and thyroid disruption and there鈥檚 also an established connection between untreated hypothyroidism in pregnancy and adverse outcomes in children,鈥� says Hall. 鈥淥ur latest study may provide a potential mechanism to explain links to lower IQs in boys born to mothers with higher fluoride exposure and is part of a growing body of evidence that suggests that prenatal fluoride exposure may be linked to worse cognitive outcomes for children.鈥�

The study, published today in Science of the Total Environment, followed more than 1,500 women enrolled in the  study, an ongoing, multi-year study led by Health Canada to investigate the impact of environmental chemicals on vulnerable populations, including pregnant people and infants. Women were recruited from 10 cities across Canada, seven of which have fluoridated drinking water. The researchers only studied women who reported drinking tap water in pregnancy. The women were followed throughout pregnancy and their children were also followed after birth into early childhood. 

In the study, a half-milligram-per litre increase in drinking-water fluoride levels, which may not sound like much, but is roughly the difference in exposure level between a fluoridated and non-fluoridated community, was associated with a 1.65 increase in odds of having a diagnosis or meeting criteria for hypothyroidism in pregnancy.

鈥淭his translates into a 65 per cent increase in risk,鈥� says , Hall鈥檚 supervising professor, senior author on the study and a clinical neuropsychologist who heads up the Faculty of Health鈥檚 Till Lab, which studies how various environmental exposures affect children鈥檚 health. 鈥淭he findings are concerning because hypothyroidism is a known cause of brain-based disorders in children,鈥� says Till.

Hall and Till say they hope that policy makers will consider this new research when evaluating the safety of community water fluoridation. 

Previous research looking into the link between fluoride exposure and hypothyroidism has mostly been done with lab animals, and children and adults living in parts of the world where fluoride levels are naturally high. Fluoride鈥檚 ability to suppress the thyroid has been known since the 1930s when it was used to treat overactive thyroid, also known as hyperthyroidism. 

The mechanism by which fluoride may interfere with thyroid function is not entirely clear, says Hall, although she says that it may interfere with certain enzymes and iodine absorption, which is critical for thyroid hormone production. 

Women in general are more at risk of developing hypothyroidism, a condition where the body does not synthesize enough thyroid hormones and can lead to symptoms such as fatigue, weight gain and depression. In pregnancy, the demands put on the thyroid system increase substantially, especially in the first trimester when the fetus is solely reliant on maternal thyroid hormones. 

The researchers measured exposure to fluoride from tap water and other dietary sources such as black tea, which is naturally high in fluoride. The researchers also measured urinary fluoride levels and found no link with hypothyroidism. The researchers say fluoride levels in tap water may be a more reliable indicator of long-term fluoride exposure than urinary levels, which might better correlate with short-term exposure, they say.

Approximately four in 10 Canadians and seven out of 10 Americans on public water supplies have fluoridated drinking water. Fluoride compounds are added to tap water as a way to reduce cavities at the population level and this is a major source of fluoride exposure. 

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91亚色 is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change, and prepare our students for success. 91亚色's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. 91亚色鈥檚 campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future. 

Media Contact: 

Emina Gamulin, 91亚色 Media Relations, 437-217-6362, egamulin@yorku.ca

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