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Risk factors of cesarean delivery at prenatal care, admission and during labor in low-risk pregnancy: Multivariate logistic regression analysis

Authors


Dr Soo Young Kim, Department of Preventive Medicine, Eulji University Hospital, 1306 doonsan-dong, Daejeon 302-120, Korea. Email: kimsooy@eulji.ac.kr

Abstract

Aim:  Risk assessment for cesarean delivery is not a one-time assessment, but rather a procedure that continues throughout pregnancy and labor. The objective of this study was to develop models to determine risk factors of cesarean delivery in three stages in low-risk pregnancy.

Material and Methods:  The period from pregnancy to childbirth was divided into three stages, including prenatal care, admission and labor. Multivariable logistic regression analysis was used to develop three risk assessment models according to these stages, which were compared by areas under receiver operating characteristic (ROC) curves.

Results:  We developed three predictive models with different risk factors. The ability of each model to determine the risk of cesarean delivery differed according to the three stages. The ROC curve values differed significantly between the labor (model III) and prenatal care (model I) or admission (model II) models (z = 11.43, P < 0.001; z = 8.18, P < 0.001, respectively). There was also a difference in the ROC between models I and II (z = 6.76, P < 0.001).

Conclusion:  This study shows that the models constructed for the more advanced stages of pregnancy were the more accurate risk factors of cesarean delivery. Therefore, the risk assessment model for cesarean delivery should be differently adapted according to each stage.

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