title: Prediction of dystocia-related cesarean section risk in uncomplicated Taiwanese nulliparas at term.
abstract: OBJECTIVE
  We aimed to assess risk factors for dystocia-related cesarean section (CS) in uncomplicated Taiwanese nulliparas at term
  
  
  METHODS
  We reviewed 1,272 deliveries by 1 obstetrician in a Taiwanese hospital between February 2004 and December 2011. These parturients were nulliparas with singleton pregnancies ≥ 37 weeks gestation who had liveborn cephalic deliveries. The CS group consisted of parturients with dystocia-related CS for the following indications: prolonged latent phase, failure to progress, or arrest of descent. Eight confounding variables [maternal age, height, weight, body mass index (BMI) in labor, gestational age, infant birth weight, gender, and cervical dilatation] were obtained from the medical records. Multivariate logistic regression analysis was used to determine the association between each variable and route of delivery. A predictive formula for CS probability was generated using a logistic regression model.
  
  
  RESULTS
  Overall 15.0 % of nulliparas in our population underwent CS. Logistic regression analysis revealed a significant association between maternal BMI and CS (adjusted OR 1.112; 95 % CI 1.065-1.161; P < 0.001). The association between maternal age and CS was also statistically significant (adjusted OR 1.074, 95 % CI 1.033-1.116, P = 0.001). Maternal height, weight in labor, gestational age, infant birth weight, gender, and cervical dilatation were not significantly associated with the route of delivery. A predictive formula for CS probability was developed based on a combination of maternal BMI and age.
  
  
  CONCLUSIONS
  Our results show that maternal age and BMI in labor are significantly associated with dystocia-related CS in uncomplicated Taiwanese nulliparas at term. We develop a practical formula to predict the probability for CS. Using this formula, obstetricians can estimate the risk of CS according to maternal age and BMI in labor.
authors: Department of Obstetrics and Gynecology, Ton-Yen General Hospital, No.69, Sianjheng 2nd Rd, Jhubei City, 302, Hsinchu County, Taiwan, ROC, chiunghuiwu@yahoo.com.tw.
authors: Chiung-Hui
authors: CH
authors: Wu
authors: Chiu-Fen
authors: CF
authors: Chen
authors: Chi-Chen
authors: CC
authors: Chien
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D004420:Dystocia / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D047929:Term Birth; D055815:Young Adult