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Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches
OBJECTIVE: To determine risk factors for cesarean delivery in nulliparas at labor admission. STUDY DESIGN: Nulliparas with liveborn, singleton gestations ≥37 weeks in spontaneous or induced labor were analyzed from the Consortium on Safe Labor database in a retrospective observational study. Classif...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342275/ https://www.ncbi.nlm.nih.gov/pubmed/25254334 http://dx.doi.org/10.1038/jp.2014.179 |
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author | Kominiarek, Michelle A. VanVeldhuisen, Paul Gregory, Kimberly Fridman, Moshe Kim, Hajwa Hibbard, Judith U. |
author_facet | Kominiarek, Michelle A. VanVeldhuisen, Paul Gregory, Kimberly Fridman, Moshe Kim, Hajwa Hibbard, Judith U. |
author_sort | Kominiarek, Michelle A. |
collection | PubMed |
description | OBJECTIVE: To determine risk factors for cesarean delivery in nulliparas at labor admission. STUDY DESIGN: Nulliparas with liveborn, singleton gestations ≥37 weeks in spontaneous or induced labor were analyzed from the Consortium on Safe Labor database in a retrospective observational study. Classification and regression tree (CART) and multivariate logistic regression analysis determined risk factors for cesarean delivery. RESULT: Of the 66,539 nulliparas, 22% had a cesarean delivery. In the CART analysis, the first cervical dilation exam was the first branch followed by body mass index (BMI). Cesarean deliveries occurred in 45%, 25%, 14%, and 10% of deliveries at <1cm, 1-3cm, 4cm, and ≥5cm dilated respectively. The BMI influence was most evident in the <1cm dilation category with 26% of BMI<25 and 66% of BMI≥40 having a cesarean delivery. The fewest cesarean deliveries (5%) occurred in those ≥5cm and BMI<25. In the multivariate regression analysis, first cervical dilation exam <1cm (OR 5.1, 95%CI 4.5-5.7; reference ≥5cm) and BMI≥40 (OR 5.1, 95%CI 4.6-5.7; reference BMI<25.0) had the highest odds for cesarean delivery. CONCLUSION: Cervical dilation on admission followed by BMI were the two most important risk factors for cesarean delivery identified in both CART and multivariate regression analysis. |
format | Online Article Text |
id | pubmed-4342275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
record_format | MEDLINE/PubMed |
spelling | pubmed-43422752015-09-01 Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches Kominiarek, Michelle A. VanVeldhuisen, Paul Gregory, Kimberly Fridman, Moshe Kim, Hajwa Hibbard, Judith U. J Perinatol Article OBJECTIVE: To determine risk factors for cesarean delivery in nulliparas at labor admission. STUDY DESIGN: Nulliparas with liveborn, singleton gestations ≥37 weeks in spontaneous or induced labor were analyzed from the Consortium on Safe Labor database in a retrospective observational study. Classification and regression tree (CART) and multivariate logistic regression analysis determined risk factors for cesarean delivery. RESULT: Of the 66,539 nulliparas, 22% had a cesarean delivery. In the CART analysis, the first cervical dilation exam was the first branch followed by body mass index (BMI). Cesarean deliveries occurred in 45%, 25%, 14%, and 10% of deliveries at <1cm, 1-3cm, 4cm, and ≥5cm dilated respectively. The BMI influence was most evident in the <1cm dilation category with 26% of BMI<25 and 66% of BMI≥40 having a cesarean delivery. The fewest cesarean deliveries (5%) occurred in those ≥5cm and BMI<25. In the multivariate regression analysis, first cervical dilation exam <1cm (OR 5.1, 95%CI 4.5-5.7; reference ≥5cm) and BMI≥40 (OR 5.1, 95%CI 4.6-5.7; reference BMI<25.0) had the highest odds for cesarean delivery. CONCLUSION: Cervical dilation on admission followed by BMI were the two most important risk factors for cesarean delivery identified in both CART and multivariate regression analysis. 2014-09-25 2015-03 /pmc/articles/PMC4342275/ /pubmed/25254334 http://dx.doi.org/10.1038/jp.2014.179 Text en http://www.nature.com/authors/editorial_policies/license.html#terms Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Kominiarek, Michelle A. VanVeldhuisen, Paul Gregory, Kimberly Fridman, Moshe Kim, Hajwa Hibbard, Judith U. Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title | Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title_full | Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title_fullStr | Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title_full_unstemmed | Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title_short | Intrapartum Cesarean Delivery in Nulliparas: Risk Factors Compared by Two Analytical Approaches |
title_sort | intrapartum cesarean delivery in nulliparas: risk factors compared by two analytical approaches |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342275/ https://www.ncbi.nlm.nih.gov/pubmed/25254334 http://dx.doi.org/10.1038/jp.2014.179 |
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