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

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

^AStudy Design
^BData Collection
^CStatistical Analysis
^DData Interpretation
^EManuscript Preparation
^FLiterature Search
^GFunds Collection
^*Shilei Bi and Lizi Zhang contributed equally to this work

View HTML version

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
	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
	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)
HC (cm)	323 (316.5, 330)	322 (314, 328)	0.067
AC (cm)	335 (328, 343)	328 (318.25, 339)
Neonatal weight	3320 (3012.5, 3500)	3100 (2800, 3350)
^* 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.

Back to the Article

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

Your Privacy