| Prediction of Neonatal Metabolic Acidosis in Women with a Singleton Term Pregnancy in Cephalic Presentation. | |
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MedLine Citation:
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PMID: 21815125 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We sought to predict neonatal metabolic acidosis at birth using antepartum obstetric characteristics (model 1) and additional characteristics available during labor (model 2). In 5667 laboring women from a multicenter randomized trial that had a high-risk singleton pregnancy in cephalic presentation beyond 36 weeks of gestation, we predicted neonatal metabolic acidosis. Based on literature and clinical reasoning, we selected both antepartum characteristics and characteristics that became available during labor. After univariable analyses, the predictors of the multivariable models were identified by backward stepwise selection in a logistic regression analysis. Model performance was assessed by discrimination and calibration. To correct for potential overfitting, we (internally) validated the models with bootstrapping techniques. Of 5667 neonates born alive, 107 (1.9%) had metabolic acidosis. Antepartum predictors of metabolic acidosis were gestational age, nulliparity, previous cesarean delivery, and maternal diabetes. Additional intrapartum predictors were spontaneous onset of labor and meconium-stained amniotic fluid. Calibration and discrimination were acceptable for both models ( C-statistic 0.64 and 0.66, respectively). In women with a high-risk singleton term pregnancy in cephalic presentation, we identified antepartum and intrapartum factors that predict neonatal metabolic acidosis at birth. |
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Authors:
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Michelle E M H Westerhuis; Ewoud Schuit; Anneke Kwee; Nicolaas P A Zuithoff; Rolf H H Groenwold; Eline S A Van Den Akker; Erik Van Beek; Hendrikus J H M Van Dessel; Addy P Drogtrop; Herman P Van Geijn; Guiseppe C M Graziosi; Jan M M Van Lith; Jan G Nijhuis; S Guid Oei; Herman P Oosterbaan; Martina M Porath; Robert J P Rijnders; Nico W E Schuitemaker; Lia D E Wijnberger; Christine Willekes; Maurice G A J Wouters; Gerard H A Visser; Ben Willem J Mol; Karel G M Moons |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-3 |
Journal Detail:
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Title: American journal of perinatology Volume: - ISSN: 1098-8785 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© Thieme Medical Publishers. |
Affiliation:
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Department of Obstetrics and Gynecology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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