Validation of the Prediction Model for Success of Vaginal Birth After Cesarean Delivery
Validation of the Prediction Model for Success of Vaginal Birth After Cesarean Delivery
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DOI：
10.1097/aog.0b013e3181bb0dde
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发表时间：
2009-11-01
影响因子：
7.2
通讯作者：
Saade, George
中科院分区：
文献类型：
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作者：
Costantine, Maged M.;Fox, Karin;Saade, George
目的：使用不同于其来源的患者队列来验证先前开发的剖宫产后阴道分娩 (VBAC) 预测模型。 方法：我们对所有足月孕妇（2002 年 1 月至 2007 年 8 月）进行了一项队列研究，这些孕妇曾进行过低水平剖腹产，尝试进行分娩试验。最终预测模型中使用的变量（产妇年龄、孕前体重指数、种族、既往阴道分娩、既往 VBAC 以及既往剖腹产指征）是从医疗记录中提取的，并用于计算单个女性的预测 VBAC 成功率。然后将研究人群水平的这些比率划分为十分位数，并与实际 VBAC 比率进行比较。 结果：在 545 名符合纳入标准的女性中，502 名拥有完整的可用数据。共有 262 人 (52.2%) 患有 VBAC。根据回归方程计算，成功试产的患者（中位数 78.4%，四分位数范围 62.1-88.2）的 VBAC 预测概率显着高于未成功试产的患者（中位数 59.7%，四分位数范围 50.8-75.3，P）
OBJECTIVE: To validate a previously developed vaginal birth after cesarean (VBAC) prediction model using a patient cohort different than that from which it was derived.METHODS: We performed a cohort study of all term pregnant women (January 2002-August 2007) with one prior low transverse cesarean delivery attempting a trial of labor. Variables used in the final prediction model (maternal age, prepregnancy body mass index, ethnicity, prior vaginal delivery, prior VBAC, and indication for prior cesarean delivery) were extracted from medical records and used to calculate an individual woman's predicted VBAC success rate. These rates at the level of the study population then were partitioned into deciles and compared with the actual VBAC rates.RESULTS: Of 545 women who fit the inclusion criteria, 502 had complete data available. A total of 262 (52.2%) had VBAC. The predicted probability of VBAC, as calculated by the regression equation, was significantly higher in those who had a successful trial of labor (median 78.4%, interquartile range 62.1-88.2) than in those who did not (median 59.7%, interquartile range 50.8-75.3, P