A novel nomogram for predicting the risk of delayed onset lactogenesis II among women who delivered via cesarean section in China

This study aimed to develop a prognostic nomogram to predict the risk of delayed onset lactogenesis II (DOL II) in Chinese women who delivered via cesarean section. A total of 143 women who delivered via cesarean section in our hospital between June 2021 and May 2022 were retrospectively reviewed. A nomogram was constructed using the independent predictors extracted from the logistic regression analysis. Validation of the prognostic model was conducted using the concordance index, calibration curves and decision curve analyses (DCAs). Multivariate analyses revealed that the factors associated with DOL II after cesarean section were gestational weight gain (GWG), gestational hypertension, previous breastfeeding experience and previous insufficient lactation. The nomogram was constructed based on the above four factors. The area under the receiver operating characteristic curve was 0.801 in the validation set. The Youden index of the model was 0.49, with a sensitivity of 0.661 and a specificity of 0.829. The DCA indicated that our nomogram provided excellent positive net clinical benefits for predicting the risk of DOL II. This nomogram can provide a scientific basis for medical workers to promptly identify the risk of DOL II in women who have undergone cesarean section, prevent the occurrence of DOL II and improve the breastfeeding rate of mothers and the quality of life of newborns.