Does information available at admission for delivery improve prediction of vaginal birth after cesarean?
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.
Grobman
William A
WA
Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA. w-grobman@northwestern.edu
Lai
Yinglei
Y
Landon
Mark B
MB
Spong
Catherine Y
CY
Leveno
Kenneth J
KJ
Rouse
Dwight J
DJ
Varner
Michael W
MW
Moawad
Atef H
AH
Simhan
Hyagriv N
HN
Harper
Margaret
M
Wapner
Ronald J
RJ
Sorokin
Yoram
Y
Miodovnik
Menachem
M
Carpenter
Marshall
M
O'Sullivan
Mary J
MJ
Sibai
Baha M
BM
Langer
Oded
O
Thorp
John M
JM
Ramin
Susan M
SM
Mercer
Brian M
BM
D000328:Adult; D005260:Female; D005544:Forecasting; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015233:Models, Statistical; D010343:Patient Admission / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data* / Q000639:trends