Development and validation of a predictive model for forceps delivery risk in term singleton primiparas for early identification and labor management optimization

The study developed and validated a predictive model for identifying forceps delivery risk in primiparous women with singleton term pregnancies at the onset of the second stage of labor. The research included 346 women with forceps delivery and 346 women with spontaneous vaginal delivery from January 2017 to December 2024. Independent risk factors identified were: pre-delivery body mass index ≥ 28 kg/m², fetal abdominal circumference ≥ 340 mm, meconium-stained fluid (grade II or III), non-occipital anterior fetal position, and active phase duration ≥ 120 minutes. The model achieved an AUC of 0.775 with sensitivity of 0.688 and specificity of 0.725. The results indicate that the model enables early identification of high-risk patients and supports optimization of intrapartum care.