Does information available at delivery improve the accuracy of predicting vaginal birth after cesarean? validation of the published models in an independent patient cohort

Maged Costantine, Karin A. Fox, Luis Pacheco, Julio Mateus, Gary Hankins, William A. Grobman, George Saade

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

We sought to validate a proposed vaginal birth after cesarean (VBAC) prediction model that includes variables available at or close to delivery and compare its accuracy to one that only uses variables available at entry to care. We performed a retrospective cohort study of term pregnant women with a vertex singleton gestation attempting a trial of labor (TOL) after a single prior low transverse cesarean delivery. VBAC rates, predicted using the close to delivery model, were partitioned into deciles. The observed VBAC rate in each partition was compared with the predicted one. The accuracy of the two models was compared using the receiver operating characteristics curve. The predicted VBAC probability was higher in patients who had VBAC compared with those who failed a TOL (median [interquartile range]: 74.9% [59.6 to 86.1] versus 48.6% [35.4 to 66.7]; p < 0.001). The correlation between the observed and predicted VBAC rates was high (r = 0.98; p < 0.001). In the subset of patients who had the complete set of variables available for the two models (n = 490), the close to delivery model was more accurate. We validated the proposed VBAC prediction model in an independent cohort. Incorporating information available at delivery improves its accuracy.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalAmerican Journal of Perinatology
Volume28
Issue number4
DOIs
StatePublished - 2011

Fingerprint

Vaginal Birth after Cesarean
Trial of Labor
ROC Curve
Pregnant Women
Cohort Studies
Retrospective Studies
Pregnancy

Keywords

  • prediction model
  • trial of labor
  • Vaginal birth after cesarean

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Does information available at delivery improve the accuracy of predicting vaginal birth after cesarean? validation of the published models in an independent patient cohort. / Costantine, Maged; Fox, Karin A.; Pacheco, Luis; Mateus, Julio; Hankins, Gary; Grobman, William A.; Saade, George.

In: American Journal of Perinatology, Vol. 28, No. 4, 2011, p. 293-298.

Research output: Contribution to journalArticle

@article{6ec31a4b59164a1e95935e51bb55f258,
title = "Does information available at delivery improve the accuracy of predicting vaginal birth after cesarean? validation of the published models in an independent patient cohort",
abstract = "We sought to validate a proposed vaginal birth after cesarean (VBAC) prediction model that includes variables available at or close to delivery and compare its accuracy to one that only uses variables available at entry to care. We performed a retrospective cohort study of term pregnant women with a vertex singleton gestation attempting a trial of labor (TOL) after a single prior low transverse cesarean delivery. VBAC rates, predicted using the close to delivery model, were partitioned into deciles. The observed VBAC rate in each partition was compared with the predicted one. The accuracy of the two models was compared using the receiver operating characteristics curve. The predicted VBAC probability was higher in patients who had VBAC compared with those who failed a TOL (median [interquartile range]: 74.9{\%} [59.6 to 86.1] versus 48.6{\%} [35.4 to 66.7]; p < 0.001). The correlation between the observed and predicted VBAC rates was high (r = 0.98; p < 0.001). In the subset of patients who had the complete set of variables available for the two models (n = 490), the close to delivery model was more accurate. We validated the proposed VBAC prediction model in an independent cohort. Incorporating information available at delivery improves its accuracy.",
keywords = "prediction model, trial of labor, Vaginal birth after cesarean",
author = "Maged Costantine and Fox, {Karin A.} and Luis Pacheco and Julio Mateus and Gary Hankins and Grobman, {William A.} and George Saade",
year = "2011",
doi = "10.1055/s-0030-1271214",
language = "English (US)",
volume = "28",
pages = "293--298",
journal = "American Journal of Perinatology",
issn = "0735-1631",
publisher = "Thieme Medical Publishers",
number = "4",

}

TY - JOUR

T1 - Does information available at delivery improve the accuracy of predicting vaginal birth after cesarean? validation of the published models in an independent patient cohort

AU - Costantine, Maged

AU - Fox, Karin A.

AU - Pacheco, Luis

AU - Mateus, Julio

AU - Hankins, Gary

AU - Grobman, William A.

AU - Saade, George

PY - 2011

Y1 - 2011

N2 - We sought to validate a proposed vaginal birth after cesarean (VBAC) prediction model that includes variables available at or close to delivery and compare its accuracy to one that only uses variables available at entry to care. We performed a retrospective cohort study of term pregnant women with a vertex singleton gestation attempting a trial of labor (TOL) after a single prior low transverse cesarean delivery. VBAC rates, predicted using the close to delivery model, were partitioned into deciles. The observed VBAC rate in each partition was compared with the predicted one. The accuracy of the two models was compared using the receiver operating characteristics curve. The predicted VBAC probability was higher in patients who had VBAC compared with those who failed a TOL (median [interquartile range]: 74.9% [59.6 to 86.1] versus 48.6% [35.4 to 66.7]; p < 0.001). The correlation between the observed and predicted VBAC rates was high (r = 0.98; p < 0.001). In the subset of patients who had the complete set of variables available for the two models (n = 490), the close to delivery model was more accurate. We validated the proposed VBAC prediction model in an independent cohort. Incorporating information available at delivery improves its accuracy.

AB - We sought to validate a proposed vaginal birth after cesarean (VBAC) prediction model that includes variables available at or close to delivery and compare its accuracy to one that only uses variables available at entry to care. We performed a retrospective cohort study of term pregnant women with a vertex singleton gestation attempting a trial of labor (TOL) after a single prior low transverse cesarean delivery. VBAC rates, predicted using the close to delivery model, were partitioned into deciles. The observed VBAC rate in each partition was compared with the predicted one. The accuracy of the two models was compared using the receiver operating characteristics curve. The predicted VBAC probability was higher in patients who had VBAC compared with those who failed a TOL (median [interquartile range]: 74.9% [59.6 to 86.1] versus 48.6% [35.4 to 66.7]; p < 0.001). The correlation between the observed and predicted VBAC rates was high (r = 0.98; p < 0.001). In the subset of patients who had the complete set of variables available for the two models (n = 490), the close to delivery model was more accurate. We validated the proposed VBAC prediction model in an independent cohort. Incorporating information available at delivery improves its accuracy.

KW - prediction model

KW - trial of labor

KW - Vaginal birth after cesarean

UR - http://www.scopus.com/inward/record.url?scp=79953041723&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953041723&partnerID=8YFLogxK

U2 - 10.1055/s-0030-1271214

DO - 10.1055/s-0030-1271214

M3 - Article

VL - 28

SP - 293

EP - 298

JO - American Journal of Perinatology

JF - American Journal of Perinatology

SN - 0735-1631

IS - 4

ER -