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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
SGUL Authors: von Dadelszen, Peter Magee, Laura Ann

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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 (, 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 ( 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
29 June 2017Published
21 June 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 28662632
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