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- Title
Predictive model for risk of cesarean section in pregnant women after induction of labor.
- Authors
Hernández-Martínez, Antonio; Pascual-Pedreño, Ana; Baño-Garnés, Ana; Melero-Jiménez, María; Tenías-Burillo, José; Molina-Alarcón, Milagros; Hernández-Martínez, Antonio; Pascual-Pedreño, Ana I; Baño-Garnés, Ana B; Melero-Jiménez, María R; Tenías-Burillo, José M; Molina-Alarcón, Milagros
- Abstract
<bold>Purpose: </bold>To develop a predictive model for risk of cesarean section in pregnant women after induction of labor.<bold>Methods: </bold>A retrospective cohort study was conducted of 861 induced labors during 2009, 2010, and 2011 at Hospital "La Mancha-Centro" in Alcázar de San Juan, Spain. Multivariate analysis was used with binary logistic regression and areas under the ROC curves to determine predictive ability. Two predictive models were created: model A predicts the outcome at the time the woman is admitted to the hospital (before the decision to of the method of induction); and model B predicts the outcome at the time the woman is definitely admitted to the labor room.<bold>Results: </bold>The predictive factors in the final model were: maternal height, body mass index, nulliparity, Bishop score, gestational age, macrosomia, gender of fetus, and the gynecologist's overall cesarean section rate. The predictive ability of model A was 0.77 [95% confidence interval (CI) 0.73-0.80] and model B was 0.79 (95% CI 0.76-0.83). The predictive ability for pregnant women with previous cesarean section with model A was 0.79 (95% CI 0.64-0.94) and with model B was 0.80 (95% CI 0.64-0.96). For a probability of estimated cesarean section ≥80%, the models A and B presented a positive likelihood ratio (+LR) for cesarean section of 22 and 20, respectively. Also, for a likelihood of estimated cesarean section ≤10%, the models A and B presented a +LR for vaginal delivery of 13 and 6, respectively.<bold>Conclusion: </bold>These predictive models have a good discriminative ability, both overall and for all subgroups studied. This tool can be useful in clinical practice, especially for pregnant women with previous cesarean section and diabetes.
- Subjects
SPAIN; CESAREAN section; PRENATAL care; INDUCED labor (Obstetrics); MATERNAL health; RETROSPECTIVE studies; PREOPERATIVE risk factors; DELIVERY (Obstetrics); FETAL ultrasonic imaging; GESTATIONAL age; MULTIVARIATE analysis; PREGNANCY complications; LOGISTIC regression analysis; RELATIVE medical risk; PREDICTIVE tests; RECEIVER operating characteristic curves
- Publication
Archives of Gynecology & Obstetrics, 2016, Vol 293, Issue 3, p529
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-015-3856-1