Construction and Validation of a Prediction Model for Conversion to Cesarean Section in Primiparous Women Receiving Epidural Labor Analgesia: A Retrospective Cohort Study.

The rate of conversion to cesarean section was 15.9% in the training cohort and 15.3% in the validation cohort.

Six variables were identified as independent predictors of cesarean conversion: maternal age, intrapartum temperature, amniotic fluid characteristics, fetal heart rate status, use of oxytocin, and rupture of membranes during the first stage of labor.

In the validation cohort, the AUC was 0.763 (sensitivity 0.786, specificity 0.592), indicating consistent predictive performance.