OBJECTIVE: To develop a prediction model for cesarean delivery (CD) in the second stage of labor using classification and regression tree (CART) analysis. STUDY DESIGN: Retrospective cohort of term women who reached 10-cm dilation. The primary outcome was CD at 10-cm dilation. Logistic regression and CART analysis were performed to identify factors that best predict second-stage CD. Only factors known at the time a patient reaches 10-cm dilation were used. RESULTS: Of 5,388 subjects who reached 10 cm, 88 (1.6%) underwent CD. The logistic regression model identified 4 risk factors for CD and produced an area under the receiver operator characteristic curve of 0.75 (95% confidence interval 0.70 to 0.81). CART analysis identified the most important variable in predicting second-stage CD was a station at or higher than 0 at complete dilatation, but correctly classified only 19.3% of CD. CONCLUSION: Second-stage cesarean cannot be reliably predicted based on antenatal and intrapartum characteristics by logistic regression or CART techniques. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To develop a prediction model for cesarean delivery (CD) in the second stage of labor using classification and regression tree (CART) analysis. STUDY DESIGN: Retrospective cohort of term women who reached 10-cm dilation. The primary outcome was CD at 10-cm dilation. Logistic regression and CART analysis were performed to identify factors that best predict second-stage CD. Only factors known at the time a patient reaches 10-cm dilation were used. RESULTS: Of 5,388 subjects who reached 10 cm, 88 (1.6%) underwent CD. The logistic regression model identified 4 risk factors for CD and produced an area under the receiver operator characteristic curve of 0.75 (95% confidence interval 0.70 to 0.81). CART analysis identified the most important variable in predicting second-stage CD was a station at or higher than 0 at complete dilatation, but correctly classified only 19.3% of CD. CONCLUSION: Second-stage cesarean cannot be reliably predicted based on antenatal and intrapartum characteristics by logistic regression or CART techniques. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Hayala C C de Souza; Gleici S C Perdoná; Alessandra C Marcolin; Lawal O Oyeneyin; Olufemi T Oladapo; Kidza Mugerwa; João Paulo Souza Journal: Reprod Health Date: 2019-11-14 Impact factor: 3.223