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The Influence of Detailed Maternal Ethnicity on Cesarean Delivery: Findings from the U . S . Birth Certificate in the State of Massachusetts
Author(s) -
Edmonds Joyce K.,
Hawkins Summer S.,
Cohen Bruce B.
Publication year - 2014
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/birt.12108
Subject(s) - birth certificate , ethnic group , medicine , odds , odds ratio , demography , logistic regression , cesarean delivery , obstetrics , race (biology) , pregnancy , gynecology , population , gender studies , environmental health , biology , sociology , anthropology , genetics
Background Our objective was to examine the likelihood of primary cesarean delivery for women at low risk for the procedure in M assachusetts. Methods Birth certificate data for all births from 1996 to 2010 that were nulliparous, term, singleton, and vertex ( NTSV ; N = 427,393) were used to conduct logistic regression models to assess the likelihood of a cesarean delivery for each of the 31 ethnic groups relative to self‐identified “ A merican” mothers. The results were compared with broad classifications of race/ethnicity more commonly employed in research. Results While 23.3 percent of American women had primary cesarean deliveries, cesarean delivery rates varied from 12.9 percent for Cambodian to 32.4 percent for Nigerian women. Women from 21 of 30 ethnic groups had higher odds of a primary cesarean (range of adjusted odds ratios [ AOR s] 1.09–1.77), while only C hinese, C ambodian, and J apanese women had lower odds (range of AOR s 0.66–0.92), compared with self‐identified “ A mericans.” Using broad race/ethnicity categories, Non‐Hispanic black, H ispanic, and “ O ther” women had higher odds of cesarean delivery relative to N on‐ H ispanic white women (range of AOR s 1.12–1.47), while there were no differences for A sian or P acific I slander women. Conclusions Detailed maternal ethnicity explains the variation in NTSV cesarean delivery rates better than broad race/ethnicity categories. Different patterns of cesarean delivery between ethnic groups suggest cultural specificity related to birth culture.