Abstract

Background: The rate of cesarean delivery (CD) has been increasing rapidly worldwide, representing a major challenge to maternal and neonatal health. The predictive model proposed by Janssen was developed to estimate the risk of cesarean delivery in nulliparous women based on clinical factors assessed at hospital admission. However, the performance and applicability of this model has not yet been fully evaluated in the Vietnamese obstetric population. Objective: To investigate the clinical and paraclinical characteristics as well as pregnancy outcomes among term nulliparous women, while simultaneously validating the performance of the Janssen predictive model for cesarean delivery risk. Materials and Methods: A study was conducted on 250 low-risk nulliparous women with singleton pregnancies at Hue University of Medicine and Pharmacy Hospital. Clinical and obstetric characteristics were collected at admission. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of cesarean delivery. The Janssen predictive model was externally validated, and an extended model was developed using a variable selection methods. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and the Hosmer–Lemeshow test.