ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
External validation of calculator for cesarean delivery during induction of labor.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo validate a published risk calculator to predict cesarean delivery (CD) among singletons undergoing induction of labor.
methodsOur retrospective cohort study included singletons undergoing induction of labor. A predicted CD score was calculated for each individual based on a previously developed calculator. External validation of the calculator was assessed by the discriminative power of the model by using the area under the receiver operating characteristic curve, and by a calibration curve. The score was categorized as less than 10%, 10% to less than 30%, and 30% or greater. The primary outcome was CD. The secondary outcomes were a composite maternal adverse outcome (CMAO) and composite neonatal adverse outcome (CNAO). Multivariable Poisson regression models with robust error variance were used to estimate the association; adjusted relative risks with 95% confidence interval (CI) were calculated.
resultsAmong 548 women, 159 (29%) had CD. The area under the curve was 0.77 (95% CI 0.73-0.81), and the calibration curve and its 95% confidence band demonstrated good calibration. The likelihood of having a CD was higher in those with a score from 10% to less than 30% (adjusted relative risk [aRR] 2.65, 95% CI 1.58-4.45) and 30% or greater (aRR 5.73, 95% CI 3.55-9.25). The risk of CMAO was higher in those with a score between 10% and less than 30% (aRR 1.64, 95% CI 1.08-2.48) and 30% or greater (aRR 1.81, 95% CI 1.20-2.73). The risk of CNAO was similar across groups.
conclusionsThe previously developed prediction model demonstrated good external validity in our cohort. Our analyses suggest that a higher predicted CD score was associated with an increased likelihood of CD and CMAO.
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