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- W2000443390 abstract "To predict delivery route in nulliparas at labor admission. The Consortium on Safe Labor collected electronic data from 12 institutions on 228,668 deliveries from 2002-08. Nulliparas with live, singleton gestations ≥37 weeks having a trial of labor with known body mass index (BMI,kg/m2) at labor admission were analyzed. Classification and regression tree (CART) analysis was used to build a hierarchy of predictors for delivery route using race, age (<30 or ≥30 years), height, admission BMI (<25, 25-29.9, 30-34.9, 35-39.9, or ≥40), gestational age (37-39 or ≥40 weeks), diabetes, hypertension, admission cervical dilation (<1cm, 1-3cm, 3.5-4.5cm, or ≥5cm), and induction. Cesareans occurred in 21% of the 53,905 included cases. Characteristics more common in cesarean than vaginal deliveries were greater age and BMI, African American or Hispanic race, diabetes, hypertension, induction, and less dilated cervices, P<0.001 for all comparisons. Cervical dilation was the first branch of the CART. Cesareans occurred in 44%, 23%, 15%, and 10% at <1cm, 1-3cm, 3.5-4.5cm, and >5cm respectively. BMI was the second branch for all dilation categories. BMI>35 was associated with the most cesareans (60% for <1cm) and 19% of those with a BMI>35 and ≥5cm still had a cesarean. The BMI influence was most evident in the 3.5-4.5cm category with 8% of BMI<25 and 33% of BMI ≥40 having a cesarean. The third branch points included age, gestational age, and induction. The fewest cesareans (4.9%) occurred in those ≥5cm, BMI<25, and <40 weeks. Cervical dilation followed by maternal BMI were important predictors of delivery route in term laboring nulliparas. Given the rising cesarean rate and importance of decreasing this event in nulliparas, this provides data to encourage nulliparas and clinicians to await spontaneous labor, especially in obese patients, as the ultimate deterrent to cesarean delivery. Further research is needed to determine if interventions in labor management can impact delivery outcome." @default.
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- W2000443390 date "2011-01-01" @default.
- W2000443390 modified "2023-10-14" @default.
- W2000443390 title "679: Predicting delivery route in nulliparas with classification and regression tree analysis" @default.
- W2000443390 doi "https://doi.org/10.1016/j.ajog.2010.10.699" @default.
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