Development and Validation of Predictive Models for Vaginal Birth After Cesarean Delivery in China

Shilei Bi; Lizi Zhang; Jingsi Chen; Lijun Huang; Shanshan Zeng; Jinping Jia; Suiwen Wen; Yinli Cao; Shaoshuai Wang; Xiaoyan Xu; Feng Ling; Xianlan Zhao; Yangyu Zhao; Qiying Zhu; Hongbo Qi; Lanzhen Zhang; Hongtian Li; Lili Du; Zhijian Wang; Dunjin Chen

doi:10.12659/MSM.927681

03 December 2020 : Clinical Research

Development and Validation of Predictive Models for Vaginal Birth After Cesarean Delivery in China

Shilei Bi^1ACDEF, Lizi Zhang^2ACDEF, Jingsi Chen^134AC, Lijun Huang^1BF, Shanshan Zeng^1BF, Jinping Jia^5B, Suiwen Wen^6B, Yinli Cao^7B, Shaoshuai Wang^8B, Xiaoyan Xu^8B, Feng Ling^8B, Xianlan Zhao^9B, Yangyu Zhao^10B, Qiying Zhu^11B, Hongbo Qi^12B, Lanzhen Zhang^13B, Hongtian Li^14CD, Lili Du^134ACEG*, Zhijian Wang^2AG, Dunjin Chen^134AG

DOI: 10.12659/MSM.927681

Med Sci Monit 2020; 26:e927681

Authors information Article notes Copyright and License information

¹Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
²Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
³ Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, Guangdong, China
⁴ Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, Guangdong, China
⁵Department of Obstetrics and Gynecology, Guangzhou Huadu District Maternal and Child Health Hospital, Guangzhou, Guangdong, China
⁶Department of Obstetrics and Gynecology, Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Guangzhou, Guangdong, China
⁷Department of Obstetrics and Gynecology, Northwest Women’s and Children’s Hospital, Xian, Shaanxi, China
⁸Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
⁹Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henen, China
¹⁰Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
¹¹Department of Obstetrics and Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
¹²Department of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
¹³Department of Obstetrics and Gynecology, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
¹⁴Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China

^*Corresponding Author: Lili Du, e-mail: moc.liamtoh@7018udilil
^*Corresponding Author: Dunjin Chen, e-mail: nc.ude.umhzg@nehcrdzg
^*Corresponding Author: Zhijian Wang, e-mail: moc.361@yyfnjzw

^AStudy design/planning
^BData collection/entry
^CData analysis/statistics
^DData interpretation
^EPreparation of manuscript
^FLiterature analysis/search
^GFunds collection

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Table 2 Characteristics of the pregnant women.

Variables	Cesarean (n=129)	Vaginal birth (n=884)	P
Age (years)^*	32 (30, 35)	32 (28, 35)	0.38
Height (cm)^*	160 (155, 162)	159.35 (156, 162)	0.891
Pre-weight (kg)^*	55 (49, 61)	54 (48.5, 60)	0.118
Pre-BMI (kg/m)^*			0.019
<18	9 (7%)	84 (9.5%)
18–24	85 (65.9%)	607 (68.7%)
24–30	29 (13.2%)	183 (20.7%)
≥30	6 (4.7%)	10 (1.1%)
Nationality^*			1
Han population	128 (99.2%)	874 (98.9%)
Other	1 (0.8%)	10 (1.1%)
Gravity^*	3 (2, 4)	3 (2, 3)	0.26
Parity^*	1 (1, 1)	1 (1, 1)	0.024
Abortion^*	1 (0, 1)	1 (0, 1)	0.14
Drug abortion^*	0 (0, 0)	0 (0, 0)	0.12
Artificial abortion^*	0 (0, 1)	0 (0, 1)	0.07
Spontaneous abortion^*	0 (0, 0)	0 (0, 0)	0.016
Vaginal deliver history^*	8 (6.2%)	117 (13.2%)	0.023
Preterm history^*	15 (11.6%)	202 (22.9%)	0.004
PROM history^*	4 (3.1%)	37 (4.2%)	0.81
PP history^*	3 (2.3%)	12 (1.4%)	0.42
Placenta abruption history^*	1 (0.8%)	2 (0.2%)	0.34
Emergency cesarean history^*	56 (43.4%)	386 (43.7%)	0.96
Weight gain (kg)	13 (10, 16)	12 (10, 15)	0.17
Weight (kg)	69 (63, 75)	66.7 (61, 74)	0.03
BMI (kg/m)			0.004
<18	2 (1.6%)	1 (0.1%)
18–24	21 (16.3%)	174 (19.7%)
24–30	76 (58.9%)	574 (64.9%)
≥30	30 (23.3%)	135 (15.3%)
ART	2 (1.6%)	18 (2%)	1
Interval months			0.07
Gestational days	276 (271, 280.5)	273 (266, 279)	0
Source			0.048
Hospital	108 (83.7%)	792 (89.6%)
Referral	21 (16.3%)	92 (10.4%)
PROM	43 (33.3%)	187 (21.2%)	0.002
Antepartum hemorrhage	3 (2.3%)	71 (8%)	0.017
Tenderness of lower uterine segment	12 (9.3%)	168 (19%)	0.007
PP	0	3 (0.3%)	1
PAS	3 (2.3%)	3 (0.3%)	0.03
Polyhydramnios	1 (0.8%)	9 (1%)	1
Oligohydramnios	6 (4.7%)	18 (2%)	0.068
Macrosomia	5 (3.9%)	16 (1.8%)	0.12
FGR	2 (1.6%)	16 (1.8%)	1
Preeclampsia	5 (3.9%)	14 (1.6%)	0.073
GDM	22 (17.1%)	136 (15.4%)	0.625
ICP	2 (1.6%)	4 (0.5%)	0.17
Thyroid disease	0	9 (1%)	0.613
Balloon induction	12 (9.3%)	25 (2.8%)	0
Oxytocin induction	19 (14.7%)	29 (3.3%)	0
Artificial rupture of membrane induction	5 (3.9%)	37 (4.2%)	0.869
BPD (cm)	92 (89, 94)	91 (88, 93)	0.06
FL (cm)	71 (69, 72)	70 (68, 71)	<0.05
HC (cm)	323 (316.5, 330)	322 (314, 328)	0.067
AC (cm)	335 (328, 343)	328 (318.25, 339)	<0.05
Neonatal weight	3320 (3012.5, 3500)	3100 (2800, 3350)	<0.05
^* Variables were included in first trimester full model. AC – abdominal circumference; ART – artificial assisted reproductive technology; BMI – body mass index; BPD – biparietal diameter; FGR – fetal growth restriction; FL – femur length; GDM – gestational diabetes mellitus; HC – head circumference; ICP – intrahepatic cholestasis of pregnancy; PA – placenta accrete spectrum; Pre-weight – weight before pregnancy; Pre-BMI – body mass index before pregnancy; PP – placenta previa; PROM – premature rupture of membrane.

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Development and Validation of Predictive Models for Vaginal Birth After Cesarean Delivery in China

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