LeFevre M, Williamson H A, Hector M
Department of Family and Community Medicine, University of Missouri, Columbia 65212.
J Fam Pract. 1989 Jun;28(6):691-5; discussion 695-6.
A study was undertaken to evaluate Coopland's obstetric risk index in a rural primary care setting. Information on 635 pregnant women cared for in a rural practice was collected prospectively. Adverse outcome was defined as perinatal death, birthweight less than 2500 g, 5-minute Apgar score less than 7, or newborn transferred to a level 2 or level 3 nursery. Forty-seven pregnancies (8.3%) had an adverse outcome. There was a clear relationship between risk score and probability of adverse outcome. Good sensitivity could be achieved only at the expense of a very high false-positive rate, however. The index can be used to identify a subgroup of women at relatively high risk for adverse outcome, but the majority of adverse outcomes will occur in women identified as low risk. The risk-scoring system in this population was no more effective than a policy that would refer all women with standard obstetric risk factors.
一项研究旨在评估在农村基层医疗环境中库普兰产科风险指数。前瞻性收集了在农村诊所接受护理的635名孕妇的信息。不良结局定义为围产期死亡、出生体重低于2500克、5分钟阿氏评分低于7分或新生儿转入二级或三级新生儿重症监护室。47例妊娠（8.3%）出现不良结局。风险评分与不良结局的概率之间存在明显关系。然而，只有以非常高的假阳性率为代价才能实现良好的敏感性。该指数可用于识别不良结局风险相对较高的女性亚组，但大多数不良结局将发生在被确定为低风险的女性中。该人群中的风险评分系统并不比将所有具有标准产科风险因素的女性转诊的政策更有效。
