Lehmann Sjur, Baghestan Elham, Børdahl Per, Ebbing Marta, Irgens Lorentz, Rasmussen Svein
Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
Acta Obstet Gynecol Scand. 2017 Jul;96(7):892-897. doi: 10.1111/aogs.13115. Epub 2017 Mar 15.
Trial of labor (TOL) is an option in most deliveries after a previous cesarean section (CS). The Medical Birth Registry of Norway (MBRN) has received compulsory notification of all deliveries in the country since 1967, including data that could identify TOL in epidemiologic research. The objective of this study was to validate MBRN data for identification of TOL deliveries after a previous cesarean section (CS).
The MBRN provided a random national sample of 500 birth order two deliveries during 1989-2012 in women with a registered birth order one CS delivery. The reporting maternity units were asked to complete a questionnaire on data items in both deliveries, using hospital record data as the gold standard.
Completed questionnaires were returned for 477 women (95.5%) with data on both deliveries. An algorithm to identify TOL using MBRN data from the birth order two delivery had a positive predictive value of 93.2%, a negative predictive value of 93.5%, a sensitivity of 96.1%, and a specificity of 88.8%. Validity of MBRN data on mode and onset of delivery, CS subtype, and planned mode of delivery is also reported.
MBRN data on planned and actual mode of delivery, CS subtype, and the algorithm to identify TOL in deliveries after a previous CS had satisfactory quality for a registry-based study of TOL.
对于大多数曾行剖宫产的产妇而言,试产是一种分娩选择。自1967年以来,挪威医学出生登记处(MBRN)已收到该国所有分娩的强制通报,包括在流行病学研究中可用于识别试产的数据。本研究的目的是验证MBRN数据用于识别既往剖宫产术后试产分娩的情况。
MBRN提供了1989年至2012年期间500例出生顺序为二的分娩的随机全国样本,这些产妇的出生顺序为一的分娩已登记为剖宫产。要求报告的产科单位使用医院记录数据作为金标准,完成一份关于两次分娩数据项的问卷。
477名妇女(95.5%)返回了完整的问卷,包含两次分娩的数据。使用出生顺序为二的分娩的MBRN数据识别试产的算法,其阳性预测值为93.2%,阴性预测值为93.5%,敏感性为96.1%,特异性为88.8%。还报告了MBRN关于分娩方式和开始时间、剖宫产亚型以及计划分娩方式的数据的有效性。
MBRN关于计划和实际分娩方式、剖宫产亚型以及识别既往剖宫产术后试产的算法的数据,对于基于登记处的试产研究具有令人满意的质量。