Development and validation of a predictive model for forceps delivery risk in term singleton primiparas for early identification and labor management optimization - Summary - MDSpire
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Development and validation of a predictive model for forceps delivery risk in term singleton primiparas for early identification and labor management optimization
To establish and validate a predictive model for forceps-assisted delivery in term singleton primiparas during the early second stage of labor.
Approach:
Key Findings:
Independent risk factors for forceps delivery included pre-delivery BMI ≥ 28 kg/m2, fetal abdominal circumference ≥ 340 mm, grade II or III meconium-stained fluid, non-occipital anterior fetal position, and active phase duration ≥ 120 min.
The predictive model achieved an AUC of 0.775 (95% CI: 0.741–0.810), with a sensitivity of 0.688 and specificity of 0.725.
The model demonstrated acceptable calibration and provided a net benefit over the treat-all strategy for threshold probabilities up to 0.35.
Interpretation:
The proposed model enables early risk stratification for forceps delivery in term singleton primiparas, supporting anticipatory intrapartum planning.
Limitations:
The study is retrospective and may be subject to biases inherent in such designs.
Further prospective, multicenter external validation is warranted to determine the model's real-world clinical impact and generalizability.
Conclusion:
The model aids in the early identification of high-risk cases for forceps delivery.
Claims-based target trial emulation found no clear association between continued GLP-1 receptor agonist use in early pregnancy and nonlive birth, fetal growth abnormalities, or major congenital malformations.
