An obstetric scoring system: its development and application in obstetric management.
OBJECTIVE
To develop a statistically derived but clinically usable antenatal risk scoring system.


METHODS
Data from 20,985 pregnancies were statistically analyzed to identify significant risk factors. Logistic regression analysis was then used to produce a final scoring system, which was subsequently tested for validity on a separate population of 3120 pregnancies.


RESULTS
Twenty-seven significant antenatal variables were included in the final scoring system. Application of the system in early pregnancy resulted in a predictive accuracy of 0.73; at the onset of labor, predictive accuracy was 0.91. At the time of labor, 87% of poor outcomes were accurately identified by allocation of only 16% of the women to the high-risk group.


CONCLUSIONS
It was possible to develop a risk scoring system with a predictive accuracy higher than any previously reported statistically derived score. Summation of the logistic coefficients provides a score that by comparison with a chosen threshold identifies a high-risk pregnancy. In this way, despite the complexity of statistical analysis, all clinicians can quickly apply this scoring system.
Knox
A J
AJ
Department of Obstetrics and Gynecology, National Women's Hospital, Auckland, New Zealand.
Sadler
L
L
Pattison
N S
NS
Mantell
C D
CD
Mullins
P
P
D000043:Abstracting and Indexing; D000328:Adult; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009017:Morbidity; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000145:classification*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors