Preliminary Exploration and Validation of a Prediction Model for Delay Onset of Lactation Stage II in Cesarean Section Parturients

Minrong MA; Juyu ZHANG; Ling LI; Juan LI; Zhiqiong ZOU; Danning ZHANG

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Minrong MA, Juyu ZHANG, Ling LI, Juan LI, Zhiqiong ZOU, Danning ZHANG. Preliminary Exploration and Validation of a Prediction Model for Delay Onset of Lactation Stage II in Cesarean Section Parturients[J]. Journal of Kunming Medical University.

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Preliminary Exploration and Validation of a Prediction Model for Delay Onset of Lactation Stage II in Cesarean Section Parturients

Department of Obstetrics，Kunming Maternal and Child Health Care Hospital，Kunming Yunnan 650031，China

Received Date: 2026-04-17
Available Online: 2026-05-24

Abstract

Abstract

Objective To explore and a prediction model for Delayed Onset of Lactogenesis II （DOL II） in parturients who underwent cesarean section. Methods A convenience sampling method was used to select 651 parturients who delivered by cesarean section at a Grade A tertiary maternal and child health hospital in Kunming from December 2023 to January 2025. Participants were randomly divided into a modeling group （456 cases） and a validation group （195 cases）. Lasso-logistic regression was used to construct the prediction model for DOL II. A nomogram was plotted, and its predictive performance was evaluated. Results Among the 456 cesarean section parturients in the modeling group, 92 cases developed DOL II, with an incidence rate of 20.18%. Among the 195 cesarean section parturients in the validation group, 32 cases developed DOL II, with an incidence rate of 16.41%. The results of Logistic regression analysis showed that the average daily water intake after surger: 1000-1500 mL （OR: 5.700）, BMI at delivery （OR: 1.155）, Edinburgh Postnatal Depression Scale score （OR: 2.521）, Pittsburgh Sleep Quality Index score （OR: 3.457）, and Breastfeeding Self-Efficacy Scale-Short Form score （OR: 0.939） were the influencing factors of DOL II in cesarean section parturients. The prediction model based on these factors showed good discrimination, with Area Under the Receiver Operating Characteristic （ROC） Curve （AUC） values of 0.83 [95% Confidence Interval （CI）（0.78, 0.87）] in the modeling group and 0.76［95%CI（0.66, 0.85）］in the validation group. The Hosmer-Lemeshow goodness-of-fit test yielded X² values of 8.773 and 5.002 （both P > 0.05） for the modeling and validation groups, respectively. The calibration curves drawn were close to the ideal curve, indicating good calibration. Conclusions The prediction model constructed in this study provides instrumental support for obstetric nursing staff to early identify high-risk groups of DOL II among parturients undergoing cesarean section and develop targeted nursing interventions.
- Cesarean section,
- Puerperas,
- Delayed onset of lactogenesis,
- Predictive model,
- Nursing

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