{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:25:50Z","timestamp":1787621150612,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005925","name":"Robert H. Smith International Center for Jefferson Studies, Thomas Jefferson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The objective of this paper was to identify predictors of a vaginal birth in individuals with singleton pregnancies and a Bishop Score &lt;4, following Induction of Labor (IoL) using dinoprostone vaginal insert (DVI). Secondarily, we sought to understand the association between oxytocin use for labor augmentation and IoL outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed and internally validated a multivariate prediction model using machine learning (ML) applied to data from two Phase\u2010III randomized controlled double\u2010blind trials (NCT01127581, NCT00308711). The model was internally validated using 10\u2010fold cross\u2010validation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 1107 participants. Despite unfavorable cervical status and inclusion of high\u2010risk pregnancies, 72% of participants had vaginal births. The model's area under receiver operating characteristic curve was 0.73. The following factors increased the chance of vaginal birth: being parous; being between 37 and 41\u2009weeks of gestation; having a lower Body Mass Index; having a lower maternal age; having fewer maternal comorbidities; and having a higher Bishop score. Parity alone correctly predicted the outcome in ~50% of cases, at a ~10% false\u2010negative rate.<\/jats:p><jats:p>Participants whose labors progressed without requiring oxytocin had a higher probability of vaginal birth than those requiring oxytocin for either induction or augmentation (81% vs 70% vs 77%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Even in high\u2010risk pregnancies and with low Bishop scores, the use of DVI results in a high chance of vaginal birth. Parity is a critical predictor of success. The judicious use of oxytocin for labor induction or augmentation can increase the chance of vaginal birth. Our study validates the use of ML and predictive modeling for treatment response prediction when considering IoL<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12691","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T06:46:35Z","timestamp":1671691595000},"page":"234-243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prediction of successful labor induction in persons with a low Bishop score using machine learning: Secondary analysis of two randomized controlled trials"],"prefix":"10.1111","volume":"50","author":[{"given":"Rohan","family":"D'Souza","sequence":"first","affiliation":[{"name":"Departments of Obstetrics &amp; Gynaecology and Health Research Methods, Evidence &amp; Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orla","family":"Doyle","sequence":"additional","affiliation":[{"name":"IQVIA  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Miller","sequence":"additional","affiliation":[{"name":"Watching Over Mothers &amp; Babies Foundation  Tuscon Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Pillai","sequence":"additional","affiliation":[{"name":"IQVIA AG Basel Area  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzanna","family":"Angehrn","sequence":"additional","affiliation":[{"name":"IQVIA AG Basel Area  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Li","sequence":"additional","affiliation":[{"name":"Ferring International  Saint\u2010Prex Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Ispas\u2010Jouron","sequence":"additional","affiliation":[{"name":"Ferring International  Saint\u2010Prex Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Disease Control and Prevention.National Vital Statistics Reports.https:\/\/www.cdc.gov\/nchs\/products\/nvsr.htm. Published 2022. Accessed October 18 2022."},{"key":"e_1_2_10_3_1","first-page":"1","article-title":"Recent declines in induction of labor by gestational age","volume":"155","author":"Osterman MJ","year":"2014","journal-title":"NCHS Data Brief"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130925"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800566"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13589"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.202434"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2022.01.006"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.25582"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2021.12.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318187042e"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31829a2dd6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1974.tb00362.x"},{"key":"e_1_2_10_15_1","volume-title":"Williams Obstetrics","author":"Cunningham FGGNLK","year":"2001"},{"issue":"2011","key":"e_1_2_10_16_1","first-page":"2825","article-title":"Scikit\u2010learn: Machine Learning in Python","volume":"12","author":"Pedregosa F","year":"2012","journal-title":"Journal of Machine Learning Research"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","unstructured":"SeaboldS PerktoldJ.Statsmodels: Econometric and Statistical Modeling with Python. Proceedings of the 9th Python in Science Conference 2010.","DOI":"10.25080\/Majora-92bf1922-011"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3856-1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-016-4260-1"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.603"},{"key":"e_1_2_10_21_1","first-page":"289","article-title":"Can the outcome of labour woth oral misoprostol be predicted?","volume":"97","author":"Mbele A","year":"2007","journal-title":"South African Medical Journal = Suid\u2010Afrikaanse tydskrif vir geneeskunde"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2232-8"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1608847"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ad9377"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.04.027"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001083"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.07.003"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2021.08.006"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2021.12.004"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12935"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2019.100041"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.651"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1745180"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aax2342"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14865"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17499"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.12691","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T11:32:53Z","timestamp":1692531173000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.12691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,21]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/birt.12691"],"URL":"https:\/\/doi.org\/10.1111\/birt.12691","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,21]]},"assertion":[{"value":"2022-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}