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This study used\u00a0second-trimester ultrasound biometry and Doppler velocimetry were used to construct six FGR (birthweight\u2009&lt;\u20093rd centile) ML models. Interpretability analysis was conducted using Accumulated Local Effects (ALE) and Shapley Additive Explanations (SHAP). The results were compared with clinical guidelines based on the most optimal model. Support Vector Machine\u00a0(SVM) exhibited the most consistent performance in FGR prediction. SHAP showed that the top contributors to identify FGR were Abdominal Circumference (AC), NF, Uterine RI (Ut RI), and Uterine PI (Ut PI). ALE showed that the cutoff values of Ut RI, Ut PI, and AC in differentiating FGR from normal were comparable with clinical guidelines (Errors between model and clinical; Ut RI: 15%, Ut PI: 8%, and AC: 11%). The cutoff value for NF to differentiate between healthy and FGR is 5.4\u00a0mm, where low NF may indicate FGR. The SVM model is the most stable in FGR prediction. ALE can be a potential tool to identify a cutoff value for novel parameters to differentiate between healthy and FGR.<\/jats:p>","DOI":"10.1038\/s41598-022-07883-0","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T06:06:06Z","timestamp":1646892366000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Interpreting the role of nuchal fold for fetal growth restriction prediction using machine learning"],"prefix":"10.1038","volume":"12","author":[{"given":"Lung Yun","family":"Teng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Citra Nurfarah Zaini","family":"Mattar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arijit","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Lam","family":"Hoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shier Nee","family":"Saw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"7883_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/1824-7288-37-41","volume":"37","author":"T Saleem","year":"2011","unstructured":"Saleem, T. et al. 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