†These authors contributed equally.
Academic Editor: Michael H. Dahan
Background: Some models predicting cesarean section (CS) have
been proposed, with Tolcher, Levine, and Burke model well acknowledged. Tolcher
model targets nulliparous women with term labor induction; Levine model targets
women with term labor induction with intact membranes and an unfavorable cervix.
Burke model targets term nulliparous woman with an uncomplicated pregnancy. Our
objective was to assess the predictive performance of these three models, and to
disclose the variables which may predict the risk of CS in Chinese population.
Methods: A retrospective study was conducted on women with singleton,
term, cephalic pregnancies at a tertiary academic center (2011–2017). A
predicted probability for CS was calculated for women in the dataset by the
algorithm of each model. The performance of the model was evaluated for
discrimination. Univariate analysis was used to screen out the factors that may
increase the risk of CS. Results: The three models predicted CS as
following (expressed by an area under the receiver operating characteristic curve
[AUC ROC]) (in the population defined/employed by each model): Tolcher model with
AUC ROC of 0.659; Levine model with 0.697; and Burke model as 0.623. Different
interventional measures or characteristics of labor were also evaluated; the
nulliparous and multiparous were analyzed separately. Still, most of the results
were unsatisfactory (AUC ROC