Research on Influencing Factors and Prediction Model of Induced Labor in Patients with Fetal Growth Restriction

Yan Mingxing; Li Liying; Wang Jinji

doi:10.3969/j.issn.1004-5775.2025.10.008

Abstract：Objective:To research the factors of vaginal delivery after induced labor in full-term pregnancies with fetal growth restriction(FGR),build a logistic regression model for predicting successful labor,and evaluate the discrimination and calibration.Methods:Retrospectively analysis of 318 FGR patients induced by dinoprostone or COOK cervical dilation balloon in Fujian Maternal and Child Health Hospital from Jan.2017 to Dec.2021 was conducted.According to the mode of delivery,they were divided into two groups:vaginal delivery and cesarean section.We collected the baseline data of patients,prenatal factors and neonatal outcomes.Logistic regression model was built to predict the probability of vaginal birth in FGR patients after induced labor.Results:247 patients were birthed by vaginal delivery and 71 cases were ended by cesarean section.The success rate of vaginal delivery was 77.67%.Logistic regression analysis found that labor time,Bishop score after labor induction,dinoprostol induction were positively correlated with labor induction effect(OR=3.169,1.513,1.789;P＜0.05),and age was negatively correlated with labor induction outcome(OR=0.866,P＜0.05).The area under ROC curve established by logistic regression model to predict the outcome of induction of labor was 0.746(95%CI:0.687～0.806),which had good prediction value.The optimal diagnostic threshold was 0.831,the sensitivity was 52.6%,and the specificity was 87.3%.H-L test showed that the prediction model P＞0.05,the model has a good degree of fit,calibration ability is good.Conclusion:It is safe for FGR patients to use dinoprostone for labor induction,and the vaginal delivery rate is higher than those with COOK cervical dilatation balloon.Age,parity and Bishop score after cervical ripening and dinoprostone can be used as predictive indexes for the probability of vaginal birth after induced labor.The establishment of logistic regression analysis model is helpful to built a logistic regression model to guide doctors to choose suitable plan for FGR patients,and provide new ideas for decision-making of labor induction.