Construction of a risk prediction model for cesarean section after failed vaginal trial of labor and analysis of maternal and infant outcomes
Objective To construct a risk prediction model for cesarean section after failed vaginal trial of labor and analyze related maternal and infant outcomes. Methods A total of 272 pregnant women admitted to the Department of Obstetrics of Jiaxing Maternal and Child Health Hospital from January 2023 to March 2024 were retrospectively selected as the research objects. Among them,172 pregnant women who underwent cesarean section after failed vaginal trial of labor were set as the observation group,and 100 pregnant women who successfully delivered vaginally after trial of labor were set as the control group. Univariate analysis was performed on the pregnancy data of the two groups of pregnant women. Factors with P<0.05 in univariate analysis were included in multivariate logistic regression analysis to screen out the independent influencing factors of cesarean section after failed vaginal trial of labor. According to the β value of independent influencing factors,a risk prediction model was constructed. The ROC curve was used to evaluate the efficacy of the risk prediction model in predicting cesarean section after failed vaginal trial of labor. The maternal and infant outcomes of the two groups were compared. Results The BMI at delivery,uterine height,fetal biparietal diameter,and induction proportion of pregnant women in the observation group were all higher than those in the control group,and the cervical Bishop score and the proportion of multiparous women were lower than those in the control group,with statistically significant (all P<0.05). Multivariate logistic regression analysis showed that high BMI at delivery was an independent risk factor for cesarean section after failed vaginal trial of labor (P<0.05),and high cervical Bishop score and multiparity were independent protective factors for cesarean section after failed vaginal trial of labor (both P<0.05). According to the β value of each influencing factor,a risk prediction model was established. The risk prediction model=0.259×BMI at delivery-0.353×cervical Bishop score-2.180×multiparity. ROC curve analysis showed that the AUC of the risk prediction model for predicting cesarean section after failed vaginal trial of labor was 0.862,which was higher than that of BMI at delivery (AUC=0.756),cervical Bishop score (AUC=0.729),and multiparity (AUC=0.655),and the differences were statistically significant (all P<0.01). The neonatal weight,bleeding during delivery,and neonatal asphyxia rate in the observation group were all higher than those in the control group,and the differences were statistically significant (all P<0.05). Conclusion The risk prediction model combining BMI at delivery,cervical Bishop score,and multiparity has good predictive value for cesarean section after failed vaginal trial of labor. Cesarean section after failed trial of labor increases the risk of neonatal asphyxia and bleeding during delivery.
Cesarean section after failed trial of laborDeliveryNeonatal asphyxia
万方数据
维普
