title: A modified prediction model for VBAC, in a European population.
abstract: OBJECTIVE
  The first aim of the study is to validate the Grobman's Nomogram on Italian population, and then to include other variables with the purpose to increase the accuracy of the Nomogram.
  
  
  METHODS
  This is a multicenter study in which eligible subjects were pregnant women reaching term having one prior cesarean section (CS) and then choosing for a trial of labor. Multivariate logistic regression model have been performed, and then the predicted percentages of vaginal delivery (VD) success were divided into 10 groups and compared with the observed ones.
  
  
  RESULTS
  Among 1161 women, 1100 were enrolled, of which 857 (77.9%) delivered vaginally. At the multivariate logistic regression, the variables predicting vaginal birth after cesarean (VBAC) in the validation were maternal age (p < 0.001), maternal body mass index (p = 0.007), having had a VD (p = 0.008) and recurring indication for CS (p < 0.001). By adding the two new variables in the proposed model, was reached the significance of "African ethnicity" (p = 0.037) and especially "years of education" (p = 0.032).
  
  
  CONCLUSIONS
  The Grobman's Nomogram seems to be applicable to Italian population too, even if with less accuracy than in the US population. The addition of the level of maternal education increases the accuracy of the model, underlining the importance of the social context in the choice of VBAC.
authors.affiliation: a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy .
authors.forename: Eleonora
authors.initials: E
authors.lastname: Annessi
authors.affiliation: b Statistics Unit, Department of Clinical and Diagnostic Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy .
authors.forename: Cinzia
authors.initials: C
authors.lastname: Del Giovane
authors.affiliation: c Obstetrics and Gynaecological Ward, Community Hospital "Infermi" of Rimini , Rimini , Italy , and.
authors.forename: Laura
authors.initials: L
authors.lastname: Magnani
authors.affiliation: d Obstetrics and Gynaecological Ward, Community Hospital "Ramazzini" of Carpi , Modena , Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Carossino
authors.affiliation: a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy .
authors.forename: Giulia
authors.initials: G
authors.lastname: Baldoni
authors.affiliation: c Obstetrics and Gynaecological Ward, Community Hospital "Infermi" of Rimini , Rimini , Italy , and.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Battagliarin
authors.affiliation: d Obstetrics and Gynaecological Ward, Community Hospital "Ramazzini" of Carpi , Modena , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Accorsi
authors.affiliation: a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy .
authors.forename: Facchinetti
authors.initials: F
authors.lastname: Fabio
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008875:Middle Aged; D049451:Nomograms; D011247:Pregnancy; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cesarean section; nomogram prediction; trial of labor; vaginal birth