To Establish A Prediction Model For The Induction Of Labour In Singleton Cephalic Presentation At Term Primipara

Objective:To establish a prediction model for induction of labour in singleton cephalic presentation at term primipara.Methods:This study retrospectively analyzed the clinical data of primiparaat term with singleton cephalicpresentation who had labor induced,in the Department of Obstetrics and Gynecology of Affiliated Hospital of North Sichuan Medical College from January 1,2015 to December 31,2020.According to the outcome of labor induction,they were divided into successful labor induction group and failed labor induction group.Chi-square test and multivariate logistic regression analysis were used for statistical analysis.Influencing factors of the outcome of labor induction were screened to establish the prediction model.The area under the receiver operatingcharacteristiccurve(AUC)and Hosmer-Lemeshows goodness-of-fit test were used to assess the performance of the mode.Results:(1)A total of 568 cases of full-term pregnancy with single fetal head primary parturient labor induction were included,including 463cases(81.5%)in the successful labor induction group and 105cases(18.5%)in the failed labor induction group;(2)The composition ratio of age,gestational age,parity,Bishop score,whether Foley balloon was placed in the successful labor induction group and the failed labor induction group,rupture time,chi-square test,P>0.05,no statistical difference,and PROM(premature rupture of membranes),neonatal birth weight after the grouping and the Grouping variable of BMI(body mass index)and threatened labor,chi-square test,P<0.05,have statistical significance;(3)the multi-factor logistic regression analysis results showed that BMI before delivery,neonatal birth weight,Bishop score and PROM were all independent factors contribute to the success of induced labor.Combined with clinical practice,factors with statistical differences in univariate analysis were included in Logistic regression model to establish a prediction model for successful induction of labor;(4)The AUC of the prediction model was 0.673(95%CI:0.619-0.727),with the sensitivity and specificity of 0,0.695 and 0.587,respectively,when the cut-off value was>0.1794,.and the predictive test was performed with an AUC of 0.5,P<0.001,thedifference was statistically significant.Hosmer-lemeshowGood-of-fit test showed that the models all had good fitting degrees.(P=0.997).Conclusion:(1)PROM、Bishop score、BMI before delivery and newborn birth weight were all independent factors for the outcome of induction(2)The prediction model has been established based on the independent influencing factors related to the outcome of labor induction,and the parameter variables involved in the model are easy to obtain,so the model is convenient for clinicians to use.