Timing of delivery in a high-risk obstetric population: a clinical prediction model
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...
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-017-1390-9 |
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| author | Dane A. De Silva Sarka Lisonkova Peter von Dadelszen Anne R. Synnes Canadian Perinatal Network (CPN) Collaborative Group Laura A. Magee |
| author_facet | Dane A. De Silva Sarka Lisonkova Peter von Dadelszen Anne R. Synnes Canadian Perinatal Network (CPN) Collaborative Group Laura A. Magee |
| author_sort | Dane A. De Silva |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T04:59:03Z |
| format | Article |
| id | doaj.art-cc9c18de0dce4a5c82b487fc0c7bfa0a |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-12T04:59:03Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-cc9c18de0dce4a5c82b487fc0c7bfa0a2022-12-22T00:37:17ZengBMCBMC Pregnancy and Childbirth1471-23932017-06-0117111010.1186/s12884-017-1390-9Timing of delivery in a high-risk obstetric population: a clinical prediction modelDane A. De Silva0Sarka Lisonkova1Peter von Dadelszen2Anne R. Synnes3Canadian Perinatal Network (CPN) Collaborative Group4Laura A. Magee5Department of Obstetrics & Gynaecology, University of British ColumbiaDepartment of Obstetrics & Gynaecology, University of British ColumbiaSt. George’s University Hospitals NHS Foundation TrustDivision of Neonatology, Department of Paediatrics, University of British ColumbiaDepartment of Obstetrics & Gynaecology, University of British ColumbiaMolecular & Clinical Sciences Research Institute, St. George’s University of LondonAbstract 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.http://link.springer.com/article/10.1186/s12884-017-1390-9Preterm birthPrediction modelAntenatal corticosteroids |
| spellingShingle | Dane A. De Silva Sarka Lisonkova Peter von Dadelszen Anne R. Synnes Canadian Perinatal Network (CPN) Collaborative Group Laura A. Magee Timing of delivery in a high-risk obstetric population: a clinical prediction model BMC Pregnancy and Childbirth Preterm birth Prediction model Antenatal corticosteroids |
| title | Timing of delivery in a high-risk obstetric population: a clinical prediction model |
| title_full | Timing of delivery in a high-risk obstetric population: a clinical prediction model |
| title_fullStr | Timing of delivery in a high-risk obstetric population: a clinical prediction model |
| title_full_unstemmed | Timing of delivery in a high-risk obstetric population: a clinical prediction model |
| title_short | Timing of delivery in a high-risk obstetric population: a clinical prediction model |
| title_sort | timing of delivery in a high risk obstetric population a clinical prediction model |
| topic | Preterm birth Prediction model Antenatal corticosteroids |
| url | http://link.springer.com/article/10.1186/s12884-017-1390-9 |
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