TY - JOUR
T1 - Prediction of cesarean section risk in women with gestational hypertension or mild preeclampsia at term
AU - Van Der Tuuk, Karin
AU - Van Pampus, Maria G.
AU - Koopmans, Corine M.
AU - Aarnoudse, Jan G.
AU - Van Den Berg, Paul P.
AU - Van Beek, Johannes J.
AU - Copraij, Frans J.A.
AU - Kleiverda, Gunilla
AU - Porath, Martina
AU - Rijnders, Robbert J.P.
AU - Van Der Salm, Paulien C.M.
AU - Morssink, Leonard P.
AU - Stigter, Rob H.
AU - Mol, Ben W.J.
AU - Groen, Henk
PY - 2015/8
Y1 - 2015/8
N2 - Objective In a recent randomized controlled trial we found that induction of labor in women with gestational hypertension (GH) or mild (preeclampsia) PE at term prevented high risk situations without increasing the cesarean section (CS) rate. We aimed to assess the predictability of the risk of CS. Study design We used multivariable logistic regression analysis to identify predictive factors. Two models were created, one including antepartum and one including antepartum and intrapartum variables. The predictive capacity was assessed with ROC analysis and calibration. Results 126 (17%) of the 756 women delivered by CS. In multivariable analysis parity (OR 5.4), ethnicity (OR 2.4), previous miscarriage (OR 1.7), creatinine (OR 1.02), proteinuria (OR 2.4), cervical length (OR 1.02), engagement (OR 0.5) and dilatation (OR 0.7) were independent antepartum predictors. Intrapartum variables were parity (OR 3.6), ethnicity (OR 1.9), previous miscarriage (OR 1.5), gestational age at delivery (OR 1.2), antibiotic use (OR 8.0), disease progression (OR 2.4), uric acid (OR 1.4), proteinuria (OR 3.50) and dilatation (OR 0.76). Both models showed good discrimination (AUC 0.74 and 0.80) but calibration was moderate (Hosmer-Lemeshow P-value 0.42 and 0.70). Conclusion In women with GH or mild PE at term, the risk of CS can be predicted.
AB - Objective In a recent randomized controlled trial we found that induction of labor in women with gestational hypertension (GH) or mild (preeclampsia) PE at term prevented high risk situations without increasing the cesarean section (CS) rate. We aimed to assess the predictability of the risk of CS. Study design We used multivariable logistic regression analysis to identify predictive factors. Two models were created, one including antepartum and one including antepartum and intrapartum variables. The predictive capacity was assessed with ROC analysis and calibration. Results 126 (17%) of the 756 women delivered by CS. In multivariable analysis parity (OR 5.4), ethnicity (OR 2.4), previous miscarriage (OR 1.7), creatinine (OR 1.02), proteinuria (OR 2.4), cervical length (OR 1.02), engagement (OR 0.5) and dilatation (OR 0.7) were independent antepartum predictors. Intrapartum variables were parity (OR 3.6), ethnicity (OR 1.9), previous miscarriage (OR 1.5), gestational age at delivery (OR 1.2), antibiotic use (OR 8.0), disease progression (OR 2.4), uric acid (OR 1.4), proteinuria (OR 3.50) and dilatation (OR 0.76). Both models showed good discrimination (AUC 0.74 and 0.80) but calibration was moderate (Hosmer-Lemeshow P-value 0.42 and 0.70). Conclusion In women with GH or mild PE at term, the risk of CS can be predicted.
KW - Cesarean section rate
KW - Hypertension
KW - Pre-eclampsia
KW - Prediction models
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=84943603531&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2015.05.009
DO - 10.1016/j.ejogrb.2015.05.009
M3 - Article
C2 - 26070123
AN - SCOPUS:84943603531
VL - 191
SP - 23
EP - 27
JO - European Journal of Obstetrics & Gynecology and Reproductive Biology
JF - European Journal of Obstetrics & Gynecology and Reproductive Biology
SN - 0301-2115
ER -