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Multicenter Study
. 2017 Jun 29;17(1):202.
doi: 10.1186/s12884-017-1390-9.

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

Dane A De Silva  1   2 , Sarka Lisonkova  1   2 , Peter von Dadelszen  3   4 , Anne R Synnes  5 ; Canadian Perinatal Network (CPN) Collaborative Group; Laura A Magee  6
Affiliations
Multicenter Study

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

Dane A De Silva et al. BMC Pregnancy Childbirth. .

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.

Keywords: Antenatal corticosteroids; Prediction model; Preterm birth.

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Conflict of interest statement

Ethics approval and consent to participate

The Canadian Perinatal Network received ethics approval centrally as a quality assurance project by the Research Ethics Boards at the University of British Columbia (H05–70359) and at each study site. As such, written consent was not required, and any collected information was anonymised and de-identified prior to analysis.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Graphical presentation of prognostic performance of the final model to predict delivery within 7 days of admission among a high-risk cohort. a Area under the ROC curve. b Calibration curve
See this image and copyright information in PMC

References

    1. Public Health Agency of Canada . Canadian Perinatal Health Report. Ottawa: Minister of Public Works and Government Services Canada; 2008.
    1. Magee L, Sawchuck D, Synnes A, von Dadelszen P. Magnesium Sulphate for Fetal Neuroprotection Consensus Committee. SOGC Clinical Practice Guideline. Magnesium sulphate for fetal neuroprotection. J Obstet Gynaecol Can. 2011;33(5):516–529. doi: 10.1016/S1701-2163(16)34886-1. - DOI - PubMed
    1. Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006;19(3):CD004454. - PubMed
    1. Kazem M, Hutcheon JA, Joseph KS. A population-based study of antenatal corticosteroid prophylaxis for preterm birth. J Obstet Gynaecol Can. 2012;34(9):842–848. doi: 10.1016/S1701-2163(16)35383-X. - DOI - PubMed
    1. Crane J, Armson A, Brunner M, De La Ronde S, Farine D, Keenan-Lindsay L, et al. Antenatal corticosteroid therapy for fetal maturation. J Obstet Gynaecol Can. 2003;25(1):45–52. doi: 10.1016/S1701-2163(16)31081-7. - DOI - PubMed

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