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Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population

Background  The Maternal–Fetal Medicine Units (MFMU) Network developed a prediction model for calculating the likelihood of successful vaginal birth after cesarean (VBAC) in patients undergoing a trial of labor after cesarean (TOLAC). In this prediction model, Latina ethnicity is considered a negati...

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Autores principales: Nguyen, Michelle T., Hayes-Bautista, Teodocia Maria, Hsu, Paul, Bragg, Christina, Chopin, Irving, Shaw, Kathryn J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159979/
https://www.ncbi.nlm.nih.gov/pubmed/32309016
http://dx.doi.org/10.1055/s-0040-1708493
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author Nguyen, Michelle T.
Hayes-Bautista, Teodocia Maria
Hsu, Paul
Bragg, Christina
Chopin, Irving
Shaw, Kathryn J.
author_facet Nguyen, Michelle T.
Hayes-Bautista, Teodocia Maria
Hsu, Paul
Bragg, Christina
Chopin, Irving
Shaw, Kathryn J.
author_sort Nguyen, Michelle T.
collection PubMed
description Background  The Maternal–Fetal Medicine Units (MFMU) Network developed a prediction model for calculating the likelihood of successful vaginal birth after cesarean (VBAC) in patients undergoing a trial of labor after cesarean (TOLAC). In this prediction model, Latina ethnicity is considered a negative predictive factor for successful VBAC. Subsequent studies have found mixed results regarding VBAC success in Latina ethnicity. Objective  Our aim was to compare the predicted chance of successful VBAC (as calculated using the MFMU prediction model) to actual TOLAC outcomes in a large Latina sample. Study Design  We performed a retrospective cohort study of Latinas who underwent TOLAC at our institution from January 1, 2013 to December 31, 2016. The MFMU prediction model was used to calculate each participant's predicted success, and the participants were then categorized into three groups based on predicted success: low (<35%), moderate (35–65%), and high (>65%). The predicted success rates versus actual outcomes were compared among the three groups. Results  A total of 567 Latinas met inclusion criteria. Successful VBAC occurred in 476 patients (84%). VBAC was achieved in 65.3% of the low predicted success group, 84.4% of the moderate predicted success group, and 91.7% of the predicted high success group. Actual VBAC success rates exceeded the predicted success rates for the low and moderate groups. Conclusion  Our results question whether Latina ethnicity should continue to be considered a negative predictive factor for VBAC success. Our results also suggest that Latinas with a low predicted VBAC success should not necessarily be discouraged from attempting TOLAC.
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spelling pubmed-71599792020-04-17 Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population Nguyen, Michelle T. Hayes-Bautista, Teodocia Maria Hsu, Paul Bragg, Christina Chopin, Irving Shaw, Kathryn J. AJP Rep Background  The Maternal–Fetal Medicine Units (MFMU) Network developed a prediction model for calculating the likelihood of successful vaginal birth after cesarean (VBAC) in patients undergoing a trial of labor after cesarean (TOLAC). In this prediction model, Latina ethnicity is considered a negative predictive factor for successful VBAC. Subsequent studies have found mixed results regarding VBAC success in Latina ethnicity. Objective  Our aim was to compare the predicted chance of successful VBAC (as calculated using the MFMU prediction model) to actual TOLAC outcomes in a large Latina sample. Study Design  We performed a retrospective cohort study of Latinas who underwent TOLAC at our institution from January 1, 2013 to December 31, 2016. The MFMU prediction model was used to calculate each participant's predicted success, and the participants were then categorized into three groups based on predicted success: low (<35%), moderate (35–65%), and high (>65%). The predicted success rates versus actual outcomes were compared among the three groups. Results  A total of 567 Latinas met inclusion criteria. Successful VBAC occurred in 476 patients (84%). VBAC was achieved in 65.3% of the low predicted success group, 84.4% of the moderate predicted success group, and 91.7% of the predicted high success group. Actual VBAC success rates exceeded the predicted success rates for the low and moderate groups. Conclusion  Our results question whether Latina ethnicity should continue to be considered a negative predictive factor for VBAC success. Our results also suggest that Latinas with a low predicted VBAC success should not necessarily be discouraged from attempting TOLAC. Thieme Medical Publishers 2020-04 2020-04-15 /pmc/articles/PMC7159979/ /pubmed/32309016 http://dx.doi.org/10.1055/s-0040-1708493 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Nguyen, Michelle T.
Hayes-Bautista, Teodocia Maria
Hsu, Paul
Bragg, Christina
Chopin, Irving
Shaw, Kathryn J.
Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title_full Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title_fullStr Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title_full_unstemmed Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title_short Applying a Prediction Model for Vaginal Birth after Cesarean to a Latina Inner-City Population
title_sort applying a prediction model for vaginal birth after cesarean to a latina inner-city population
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159979/
https://www.ncbi.nlm.nih.gov/pubmed/32309016
http://dx.doi.org/10.1055/s-0040-1708493
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