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The fetal heart rate (FHR) is monitored on a paper strip (cardiotocogram) during labour to assess fetal health. If necessary, clinicians can intervene and assist with a prompt delivery of the baby. Data-driven computerized FHR analysis could help clinicians in the decision-making process. However, selecting the best computerized FHR features that relate to labour outcome is a pressing research problem. The objective of this study is to apply genetic algorithms (GA) as a feature selection method to select the best feature subset from 64 FHR features and to integrate these best features to recognize unfavourable FHR patterns. The GA was trained on 404 cases and tested on 106 cases (both balanced datasets) using three classifiers, respectively. Regularization methods and backward selection were used to optimize the GA. Reasonable classification performance is shown on the testing set for the best feature subset (Cohen's kappa values of 0.45 to 0.49 using different classifiers). This is, to our knowledge, the first time that a feature selection method for FHR analysis has been developed on a database of this size. This study indicates that different FHR features, when integrated, can show good performance in predicting labour outcome. It also gives the importance of each feature, which will be a valuable reference point for further studies.

Original publication




Journal article


Physiological measurement

Publication Date





1357 - 1371


Doctoral Training Centre, University of Oxford, Rex Richards Building, South Parks Road, Oxford OX1 3QU, UK. Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Level 3, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford. Headington, Oxford OX3 7DQ, UK.


Humans, Fetal Diseases, Acidosis, Cardiotocography, Fetal Monitoring, Linear Models, ROC Curve, Pregnancy, Labor, Obstetric, Heart Rate, Fetal, Algorithms, Signal Processing, Computer-Assisted, Databases, Factual, Female