Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China
Background: Intrapartum cesarean delivery has been the focus of many researchers. We derived and validated a model to predict cesarean for low-risk Chinese nulliparous undergoing induction of labor. Methods: We developed a risk model for cesarean by including variables in univariate and multivariabl...
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| Format: | Article |
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IMR Press
2023-08-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/50/8/10.31083/j.ceog5008166 |
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| author | Fangcan Sun Fangfang Wu Huiyun Chen Qianqian Shen Youguo Chen Minhong Shen Bing Han |
| author_facet | Fangcan Sun Fangfang Wu Huiyun Chen Qianqian Shen Youguo Chen Minhong Shen Bing Han |
| author_sort | Fangcan Sun |
| collection | DOAJ |
| description | Background: Intrapartum cesarean delivery has been the focus of many researchers. We derived and validated a model to predict cesarean for low-risk Chinese nulliparous undergoing induction of labor. Methods: We developed a risk model for cesarean by including variables in univariate and multivariable logistic regression using the development set (3841 pregnant women). The performance of the model was assessed for the receiver operating characteristic (ROC) curve, calibration and decision curve analysis (DCA). Additionally, we validated the model externally using an independent dataset (3421 pregnant women). Results: Multivariable logistic regression analysis showed that age, height, body mass index (BMI), weight change during pregnancy, gestational age, premature rupture of membranes (PROM), meconium-stained amniotic fluid and neonatal sex were independent factors affecting cesarean outcome. Two models were established, depending on whether the sex of the fetus was included. The area under the ROC curve of two models were 0.755 and 0.748, respectively. We verified externally, and the area under the ROC curve of two models were 0.758 and 0.758, respectively. The calibration plots demonstrated a good correlation. DCA demonstrated that two models had clinical application value. The online web servers were constructed based on the nomograms for convenient clinical use. Conclusions: These two models can be used as useful tools to assess the risk of cesarean for low-risk Chinese nulliparous undergoing induction of labor. |
| format | Article |
| id | doaj-art-b1ee50efbfd741f5af1d89427ec5485e |
| institution | OA Journals |
| issn | 0390-6663 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | IMR Press |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-b1ee50efbfd741f5af1d89427ec5485e2025-08-20T02:00:28ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-08-0150816610.31083/j.ceog5008166S0390-6663(23)02104-8Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in ChinaFangcan Sun0Fangfang Wu1Huiyun Chen2Qianqian Shen3Youguo Chen4Minhong Shen5Bing Han6Department of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, Sihong County People's Hospital, 223999 Suqian, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, ChinaBackground: Intrapartum cesarean delivery has been the focus of many researchers. We derived and validated a model to predict cesarean for low-risk Chinese nulliparous undergoing induction of labor. Methods: We developed a risk model for cesarean by including variables in univariate and multivariable logistic regression using the development set (3841 pregnant women). The performance of the model was assessed for the receiver operating characteristic (ROC) curve, calibration and decision curve analysis (DCA). Additionally, we validated the model externally using an independent dataset (3421 pregnant women). Results: Multivariable logistic regression analysis showed that age, height, body mass index (BMI), weight change during pregnancy, gestational age, premature rupture of membranes (PROM), meconium-stained amniotic fluid and neonatal sex were independent factors affecting cesarean outcome. Two models were established, depending on whether the sex of the fetus was included. The area under the ROC curve of two models were 0.755 and 0.748, respectively. We verified externally, and the area under the ROC curve of two models were 0.758 and 0.758, respectively. The calibration plots demonstrated a good correlation. DCA demonstrated that two models had clinical application value. The online web servers were constructed based on the nomograms for convenient clinical use. Conclusions: These two models can be used as useful tools to assess the risk of cesarean for low-risk Chinese nulliparous undergoing induction of labor.https://www.imrpress.com/journal/CEOG/50/8/10.31083/j.ceog5008166intrapartum cesarean deliveryinduction of laborpredictionnulliparousnomogram |
| spellingShingle | Fangcan Sun Fangfang Wu Huiyun Chen Qianqian Shen Youguo Chen Minhong Shen Bing Han Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China Clinical and Experimental Obstetrics & Gynecology intrapartum cesarean delivery induction of labor prediction nulliparous nomogram |
| title | Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China |
| title_full | Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China |
| title_fullStr | Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China |
| title_full_unstemmed | Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China |
| title_short | Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China |
| title_sort | development and validation of models to predict cesarean delivery among low risk nulliparous women at term a retrospective study in china |
| topic | intrapartum cesarean delivery induction of labor prediction nulliparous nomogram |
| url | https://www.imrpress.com/journal/CEOG/50/8/10.31083/j.ceog5008166 |
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