Video-based detection of cessation of breathing in pre-term infants using machine learning
For clinicians in neonatal intensive care units, this work provides a non-contact method to improve respiratory monitoring robustness, though it is an incremental step as it combines existing techniques.
The study demonstrates that camera-based video monitoring can detect apnoea-related cessation of breathing in pre-term infants, with camera-only models achieving 76.9% balanced accuracy and hybrid models combining video with impedance pneumography reaching 90.6% balanced accuracy.
Pre-term infants are susceptible to potentially harmful apnoea-related cessations of breathing due to immature respiratory control. However, reliable respiratory monitoring in the neonatal intensive care unit (NICU) remains challenging because motion artefacts, sensor displacement, and skin fragility can compromise contact-based measurements. Non-contact video monitoring offers a complementary approach that does not depend on adhesive sensors while providing additional respiratory information. We investigated whether camera-based signals can detect apnoea-related cessation of breathing (COBE) and provide complementary information to routinely acquired physiological signals. Using video and clinical recordings from 30 pre-term infants, respiratory motion was extracted from dynamically tracked torso regions to generate camera-derived time-series signals. Camera-only models were trained using residual network (ResNet) architectures, while hybrid models combined video-derived signals with impedance pneumography (IP), ECG-derived respiration (EDR), and the PPG-derived respiratory envelope. Camera-only models achieved a balanced accuracy of 76.9%, demonstrating the feasibility of non-contact COBE detection. Combining video-derived features with IP improved balanced accuracy to 90.6%, outperforming either modality alone and indicating that video provides respiratory information beyond standard physiological signals. These findings show that video-derived signals contain clinically relevant respiratory features and enhance COBE detection when combined with conventional physiological signals. This supports non-contact video as a complementary modality for automated COBE detection and highlights its potential to improve the robustness of neonatal respiratory monitoring.