ArticleJournal of anesthesia2026
Development and external validation of a LASSO-based nomogram to predict epidural-associated postpartum urinary retention.
Article in Journal of anesthesia, 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
purposeTo develop and validate a risk prediction model for postpartum urinary retention (PUR) among parturients receiving epidural analgesia (EA) during vaginal delivery, to support individualized bladder management.
methodsThis dual-center retrospective cohort study analyzed electronic medical records from two hospitals (2022-2024). Least absolute shrinkage and selection operator (LASSO) regression was used to select independent predictors from demographic, labor, and analgesia-related variables. A clinical nomogram was developed. The model underwent internal and external validation; performance was assessed using calibration, discrimination (area under the receiver operating characteristic curve [AUC]), and decision curve analysis (DCA).
resultsAmong 1019 parturients receiving EA (PUR incidence 16.09%), prolonged analgesia duration and prolonged second-stage labor were independently associated with PUR, whereas higher intermittent catheterization frequency (ICF) was associated with a lower rate of recorded PUR. The model demonstrated excellent discrimination, satisfactory calibration, and clinical net benefit across validation cohorts.
conclusionThe validated nomogram provides real-time, individualized estimates of PUR risk during late labor. By identifying parturients at elevated risk, it offers an evidence-based basis for risk-adaptive bladder monitoring and individualized care; however, whether such model-guided management ultimately reduces PUR incidence remains to be established in prospective interventional studies.
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