TY - JOUR
T1 - Prediction of cesarean section risk in women with gestational hypertension or mild preeclampsia at term
AU - van der Tuuk, Karin
AU - van Pampus, Maria G.
AU - Koopmans, Corine M.
AU - Aarnoudse, Jan G.
AU - van den Berg, Paul P.
AU - van Beek, Johannes J.
AU - Copraij, Frans J. A.
AU - Kleiverda, Gunilla
AU - Porath, Martina
AU - Rijnders, Robbert J. P.
AU - van der Salm, Paulien C. M.
AU - Morssink, Leonard P.
AU - Stigter, Rob H.
AU - Mol, Ben W. J.
AU - Groen, Henk
AU - HYPITAT Study Grp
PY - 2015/8
Y1 - 2015/8
N2 - Objective: In a recent randomized controlled trial we found that induction of labor in women with gestational hypertension (GH) or mild (preeclampsia) PE at term prevented high risk situations without increasing the cesarean section (CS) rate. We aimed to assess the predictability of the risk of CS.Study design: We used multivariable logistic regression analysis to identify predictive factors. Two models were created, one including antepartum and one including antepartum and intrapartum variables. The predictive capacity was assessed with ROC analysis and calibration.Results: 126(17%) of the 756 women delivered by CS. In multivariable analysis parity (OR 5.4), ethnicity (OR 2.4), previous miscarriage (OR 1.7), creatinine (OR 1.02), proteinuria (OR 2.4), cervical length (OR 1.02), engagement (OR 0.5) and dilatation (OR 0.7) were independent antepartum predictors. Intrapartum variables were parity (OR 3.6), ethnicity (OR 1.9), previous miscarriage (OR 1.5), gestational age at delivery (OR 1.2), antibiotic use (OR 8.0), disease progression (OR 2.4), uric acid (OR 1.4), proteinuria (OR 3.50) and dilatation (OR 0.76). Both models showed good discrimination (AUC 0.74 and 0.80) but calibration was moderate (Hosmer-Lemeshow P-value 0.42 and 0.70).Conclusion: In women with GH or mild PE at term, the risk of CS can be predicted. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
AB - Objective: In a recent randomized controlled trial we found that induction of labor in women with gestational hypertension (GH) or mild (preeclampsia) PE at term prevented high risk situations without increasing the cesarean section (CS) rate. We aimed to assess the predictability of the risk of CS.Study design: We used multivariable logistic regression analysis to identify predictive factors. Two models were created, one including antepartum and one including antepartum and intrapartum variables. The predictive capacity was assessed with ROC analysis and calibration.Results: 126(17%) of the 756 women delivered by CS. In multivariable analysis parity (OR 5.4), ethnicity (OR 2.4), previous miscarriage (OR 1.7), creatinine (OR 1.02), proteinuria (OR 2.4), cervical length (OR 1.02), engagement (OR 0.5) and dilatation (OR 0.7) were independent antepartum predictors. Intrapartum variables were parity (OR 3.6), ethnicity (OR 1.9), previous miscarriage (OR 1.5), gestational age at delivery (OR 1.2), antibiotic use (OR 8.0), disease progression (OR 2.4), uric acid (OR 1.4), proteinuria (OR 3.50) and dilatation (OR 0.76). Both models showed good discrimination (AUC 0.74 and 0.80) but calibration was moderate (Hosmer-Lemeshow P-value 0.42 and 0.70).Conclusion: In women with GH or mild PE at term, the risk of CS can be predicted. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
KW - Pregnancy
KW - Hypertension
KW - Pre-eclampsia
KW - Cesarean section rate
KW - Prediction models
KW - LABOR INDUCTION
KW - ELECTIVE INDUCTION
KW - NULLIPAROUS WOMEN
KW - MATCHED COHORT
KW - DELIVERY
KW - MODELS
KW - RATES
U2 - 10.1016/j.ejogrb.2015.05.009
DO - 10.1016/j.ejogrb.2015.05.009
M3 - Article
SN - 0301-2115
VL - 191
SP - 23
EP - 27
JO - European journal of obstetrics gynecology and reproductive biology
JF - European journal of obstetrics gynecology and reproductive biology
ER -