A cry for help: Early detection of brain injury in newborns

Since the 1960s, neonatal clinicians have known that newborns suffering from certain neurological conditions exhibit altered crying patterns such as the high-pitched cry in birth asphyxia. Despite an annual burden of over 1.5 million infant deaths and disabilities, early detection of neonatal brain injuries due to asphyxia remains a challenge, particularly in developing countries where the majority of births are not attended by a trained physician. Here we report on the first inter-continental clinical study to demonstrate that neonatal brain injury can be reliably determined from recorded infant cries using an AI algorithm we call Roseline. Previous and recent work has been limited by the lack of a large, high-quality clinical database of cry recordings, constraining the application of state-of-the-art machine learning. We develop a new training methodology for audio-based pathology detection models and evaluate this system on a large database of newborn cry sounds acquired from geographically diverse settings -- 5 hospitals across 3 continents. Our system extracts interpretable acoustic biomarkers that support clinical decisions and is able to accurately detect neurological injury from newborns' cries with an AUC of 92.5% (88.7% sensitivity at 80% specificity). Cry-based neurological monitoring opens the door for low-cost, easy-to-use, non-invasive and contact-free screening of at-risk babies, especially when integrated into simple devices like smartphones or neonatal ICU monitors. This would provide a reliable tool where there are no alternatives, but also curtail the need to regularly exert newborns to physically-exhausting or radiation-exposing assessments such as brain CT scans. This work sets the stage for embracing the infant cry as a vital sign and indicates the potential of AI-driven sound monitoring for the future of affordable healthcare.