Risk factors of cesarean delivery at prenatal care, admission and during labor in low-risk pregnancy: multivariate logistic regression analysis.
OBJECTIVE
Risk assessment for cesarean delivery is not a one-time assessment, but rather a procedure that continues throughout pregnancy and labor. The objective of this study was to develop models to determine risk factors of cesarean delivery in three stages in low-risk pregnancy.


METHODS
The period from pregnancy to childbirth was divided into three stages, including prenatal care, admission and labor. Multivariable logistic regression analysis was used to develop three risk assessment models according to these stages, which were compared by areas under receiver operating characteristic (ROC) curves.


RESULTS
We developed three predictive models with different risk factors. The ability of each model to determine the risk of cesarean delivery differed according to the three stages. The ROC curve values differed significantly between the labor (model III) and prenatal care (model I) or admission (model II) models (z=11.43, P<0.001; z=8.18, P<0.001, respectively). There was also a difference in the ROC between models I and II (z=6.76, P<0.001).


CONCLUSIONS
This study shows that the models constructed for the more advanced stages of pregnancy were the more accurate risk factors of cesarean delivery. Therefore, the risk assessment model for cesarean delivery should be differently adapted according to each stage.
Departments of Obstetrics and Gynecology Nursing Preventive Medicine, Eulji University, Daejeon, Korea.
Yun Seok
YS
Yang
Myung Haeng
MH
Hur
Soo Young
SY
Kim
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007743:Labor, Obstetric; D008962:Models, Theoretical; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors