Does Information Available at Admission for Delivery Improve Prediction of Vaginal Birth after Cesarean?

被引:101
|
作者
Grobman, William A. [1 ,2 ]
Lai, Yinglei [3 ]
Landon, Mark B. [4 ]
Spong, Catherine Y. [5 ]
Leveno, Kenneth J. [6 ]
Rouse, Dwight J. [7 ]
Varner, Michael W. [8 ]
Moawad, Atef H. [9 ]
Simhan, Hyagriv N. [10 ]
Harper, Margaret [11 ]
Wapner, Ronald J. [12 ]
Sorokin, Yoram [13 ]
Miodovnik, Menachem [14 ,15 ]
Carpenter, Marshall [16 ]
O'Sullivan, Mary J. [17 ]
Sibai, Baha M. [18 ]
Langer, Oded [19 ]
Thorp, John M. [20 ]
Ramin, Susan M. [21 ]
Mercer, Brian M. [22 ]
机构
[1] Northwestern Univ, Dept Obstet, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Gynecol, Chicago, IL 60611 USA
[3] George Washington Univ, Ctr Biostat, Washington, DC USA
[4] Ohio State Univ, Columbus, OH 43210 USA
[5] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Bethesda, MD USA
[6] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA
[7] Univ Alabama Birmingham, Birmingham, AL USA
[8] Univ Chicago, Chicago, IL 60637 USA
[9] Univ Utah, Salt Lake City, UT USA
[10] Univ Pittsburgh, Pittsburgh, PA USA
[11] Wake Forest Univ, Winston Salem, NC 27109 USA
[12] Thomas Jefferson Univ, Philadelphia, PA 19107 USA
[13] Wayne State Univ, Detroit, MI USA
[14] Columbia Univ, New York, NY USA
[15] Univ Cincinnati, Cincinnati, OH USA
[16] Brown Univ, Providence, RI 02912 USA
[17] Univ Miami, Miami, FL USA
[18] Univ Tennessee, Memphis, TN USA
[19] Univ Texas San Antonio, San Antonio, TX USA
[20] Univ N Carolina, Chapel Hill, NC USA
[21] Univ Texas Houston, Houston, TX USA
[22] Case Western Reserve Univ, Cleveland, OH 44106 USA
关键词
Trial of labor; vaginal birth after cesarean; prediction; LABOR;
D O I
10.1055/s-0029-1239494
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
We sought to construct a predictive model for vaginal birth after cesarean (VBAC) that combines factors that can be ascertained only as the pregnancy progresses with those known at initiation of prenatal care. Using multivariable modeling, we constructed a predictive model for VBAC that included patient factors known at the initial prenatal visit as well as those that only become evident as the pregnancy progresses to the admission for delivery. We analyzed 9616 women. The regression equation for VBAC success included multiple factors that could not be known at the first prenatal visit. The area under the curve for this model was significantly greater (p<0.001) than that of a model that included only factors available at the first prenatal visit. A prediction model for VBAC success, which incorporates factors that can be ascertained only as the pregnancy progresses, adds to the predictive accuracy of a model that uses only factors available at a first prenatal visit.
引用
收藏
页码:693 / 701
页数:9
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