eCS risk prediction model

The information in this model describes the emergency cesarean delivery (eCS) risk prediction outcome in a term pregnancy for a population of individuals in low-risk pregnant, specifically using the prenatal obstetric and non-obstetric factors.

The model was developed using data from the CHILD cohort study, the largest-hands-on longitudinal birth cohort in Canada. The score has good national generalizability as pregnant women were recruited between 2009 and 2012 from four Canadian provinces: Alberta (Edmonton, urban), British Columbia (Vancouver, urban), Manitoba (Winnipeg, urban; Modern and Winkler, rural), and Ontario (Toronto, urban).

The eCS score included six predictors (maternal age, height, BMI, pregnancy-induced hypertension, antenatal depression, and birth order of the infant). Of note, multiple pregancy participants were excluded from the model.

Scores (from 0 – 14) were categorized into three grades (0 to 3; Table 1). Compared to grade 0, women with grade 2 had an odds ratio of 6.11 (3.06-12.19) for an emergency CS while women with a grade 3 had an odds ratio of 13.96 (7.32-26.61) for an emergency CS.

PLEASE NOTE: Information from this model is not intended to be the basis for making care decisions for an individual, nor is it intended to be a definitive means of assessing the chance of eCs in those with a term pregnancy. Users should keep in mind that every patient is an individual, and that factors beyond those described on this tool influence eCs in a term pregnancy. No data are stored through this tool.

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If you would like more information about the study, please email ( or give us a call at 825-993-2453.

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1) Maternal age?

2) Maternal height? cm

3) Maternal weight? Kg

4) Previous vaginal delivery?


5) Pregnancy induced hypertension / pre-eclampsia?


CES-D Score - Below is a list of the ways you might have felt or behaved. Please describe how often you have felt this way during the past week.

Rarely or none of the time (less than 1 day)
Some or little of the time (1-2 days)
Occasionally or a moderate amount of time (3-4 days)
Most or all of the time (5-7 days.

6) I was bothered by things that usually don´t bother me

7) I did not feel like eating; my appetite was poor

8) I felt that I could not shake off the blues even with help from my family or friends

9) I felt I was just as good as other people

10) I had trouble keeping my mind on what I was doing

11) I felt depressed

12) I felt that everything I did was an effort

13) I felt hopeful about future

14) I thought my life had been a failure

15) I felt fearful

16) My sleep was restless

17) I was happy

18) I talked less than usual

19) I felt lonely

20) People were unfriendly

21) I enjoyed life

22) I had crying spells

23) I felt sad

24) I felt people dislike me

25) I could not get going

Emergency CS grading system:

Grade 0: No Risk

Grade 1: Odds ratio of 3.28 (1.55-6.94) Risk

Grade 2: Odds ratio of 6.11 (3.06-12.19) Risk

Grade 3: Odds ratio of 13.96 (7.32-26.61) Risk