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Predictive model for risk of cesarean section in pregnant women after induction of labor

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To develop a predictive model for risk of cesarean section in pregnant women after induction of labor.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. “Mancha-Centro” Teaching Unit, Ciudad Real, Spain

    Antonio Hernández-Martínez

  2. Gynecology and Obstetrics Department at Hospital “Mancha-Centro”, Ciudad Real, Spain

    Ana I. Pascual-Pedreño

  3. Hospital “Mancha-Centro”, Ciudad Real, Spain

    Ana B. Baño-Garnés & María R. Melero-Jiménez

  4. Public Health, Ciudad Real, Spain

    José M. Tenías-Burillo

  5. University of Castilla-La Mancha, Ciudad Real, Spain

    Milagros Molina-Alarcón

  6. C/Gerona 25 Tomelloso, 13700, Ciudad Real, Spain

    Antonio Hernández-Martínez

Authors
  1. Antonio Hernández-Martínez
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  2. Ana I. Pascual-Pedreño
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  3. Ana B. Baño-Garnés
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  4. María R. Melero-Jiménez
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  5. José M. Tenías-Burillo
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  6. Milagros Molina-Alarcón
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Corresponding author

Correspondence to Antonio Hernández-Martínez.

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The authors declare that there are no conflicts of interest and that this study has been conducted with no funding.

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Hernández-Martínez, A., Pascual-Pedreño, A.I., Baño-Garnés, A.B. et al. Predictive model for risk of cesarean section in pregnant women after induction of labor. Arch Gynecol Obstet 293, 529–538 (2016). https://doi.org/10.1007/s00404-015-3856-1

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  • DOI: https://doi.org/10.1007/s00404-015-3856-1

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