Classification of cesarean sections among immigrants in Belgium.

Abstract:

OBJECTIVE:To provide insight into the differential effect of immigration on cesarean section (CS) rates, using the Robson classification. DESIGN:A population-based study using birth certificates from the birth registry of 2009. SETTING:All births in two of the three Belgian regions excluding Flanders. POPULATION:37 628 deliveries from Belgian and immigrant mothers from sub-Saharan Africa, Maghreb and Eastern Europe. METHODS:Multivariate analyses using CS as the dependent variable and immigration status as the primary independent variable. Several multivariate logistic regression models were built including medical, anthropometric, socio-economic characteristics, and medical interventions. The impact of analyzing all delivery sites together was tested using mixed-effect analyses. MAIN OUTCOME MEASURES:CSs of immigrant subgroups compared with Belgian women. RESULTS:CS rates varied according to immigrant subgroups. Mothers from sub-Saharan Africa had an adjusted odds ratio of 2.06 (1.62-2.63) for CS compared with Belgian natives. Increased risk for mothers from sub-Saharan Africa compared with Belgian natives was found among nulliparous and multiparous women without previous CS, and a term, singleton fetus in cephalic position. In comparison, nulliparous East European mothers with a term singleton fetus in cephalic position in spontaneous labor had an adjusted odds ratio of 0.29 (0.08-0.99) for CS. CONCLUSIONS:CS rates currently vary between Robson categories in immigrant subgroups. Immigrant mothers from sub-Saharan Africa with a term, singleton infant in cephalic position, without previous CS, appear to carry the highest burden.

authors

Minsart AF,De Spiegelaere M,Englert Y,Buekens P

doi

10.1111/aogs.12003

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

204-9

issue

2

eissn

0001-6349

issn

1600-0412

journal_volume

92

pub_type

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