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Timing of delivery in a high-risk obstetric population: a clinical prediction model.

De Silva, DA; Lisonkova, S; von Dadelszen, P; Synnes, AR; Canadian Perinatal Network (CPN) Collaborative Group; Magee, LA (2017) Timing of delivery in a high-risk obstetric population: a clinical prediction model. BMC Pregnancy Childbirth, 17 (1). p. 202. ISSN 1471-2393 https://doi.org/10.1186/s12884-017-1390-9
SGUL Authors: von Dadelszen, Peter Magee, Laura Ann

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Abstract

BACKGROUND: The efficacy of antenatal corticosteroid treatment for women with threatened preterm birth depends on timely administration within 7 days before delivery. We modelled the probability of delivery within 7 days of admission to hospital among women presenting with threatened preterm birth, using routinely collected clinical characteristics. METHODS: Data from the Canadian Perinatal Network (CPN) were used, 2005-11, including women admitted to hospital with preterm labour, preterm pre-labour rupture of membranes, short cervix without contractions, or dilated cervix or prolapsed membranes without contractions at preterm gestation. Women with fetal anomaly, intrauterine fetal demise, twin-to-twin transfusion syndrome, and quadruplets were excluded. Logistic regression was undertaken to create a predictive model that was assessed for its calibration capacity, stratification ability, and classification accuracy (ROC curve). RESULTS: We included 3012 women admitted at 24-28 weeks gestation, or readmitted at up to 34 weeks gestation, to 16 tertiary-care CPN hospitals. Of these, 1473 (48.9%) delivered within 7 days of admission. Significant predictors of early delivery included maternal age, parity, gestational age at admission, smoking, preterm labour, prolapsed membranes, preterm pre-labour rupture of membranes, and antepartum haemorrhage. The area under the ROC curve was 0.724 (95% CI 0.706-0.742). CONCLUSION: We propose a useful tool to improve prediction of delivery within 7 days after admission among women with threatened preterm birth. This information is important for optimal corticosteroid treatment.

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Antenatal corticosteroids, Prediction model, Preterm birth, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services, 1110 Nursing
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: BMC Pregnancy Childbirth
ISSN: 1471-2393
Language: eng
Dates:
DateEvent
29 June 2017Published
21 June 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 28662632
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108996
Publisher's version: https://doi.org/10.1186/s12884-017-1390-9

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