IMR Press / CEOG / Volume 50 / Issue 8 / DOI: 10.31083/j.ceog5008166
Open Access Original Research
Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China
Show Less
1 Department of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, China
2 Department of Obstetrics and Gynecology, Suzhou Ninth People's Hospital, 215200 Suzhou, Jiangsu, China
3 Department of Obstetrics and Gynecology, Sihong County People's Hospital, 223999 Suqian, Jiangsu, China
*Correspondence: mh_3566@163.com (Minhong Shen); hanbing@suda.edu.cn (Bing Han)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(8), 166; https://doi.org/10.31083/j.ceog5008166
Submitted: 26 November 2022 | Revised: 23 April 2023 | Accepted: 5 May 2023 | Published: 9 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

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.

Keywords
intrapartum cesarean delivery
induction of labor
prediction
nulliparous
nomogram
Funding
BXQN202222/Natural Science Foundation of the First Affiliated Hospital of Soochow University
Figures
Fig. 1.
Share
Back to top