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首页> 外文期刊>Birth >Racial and Ethnic Differences in Indication for Primary Cesarean Delivery at Term: Experience at One U.S. Institution
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Racial and Ethnic Differences in Indication for Primary Cesarean Delivery at Term: Experience at One U.S. Institution

机译：足月剖宫产手术指征的种族和种族差异：一所美国机构的经验

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Background: Black and Latina women in the United States are known to undergo cesarean delivery at a higher rate than other women. We sought to explore the role of medical indications for cesarean delivery as a potential explanation for these differences. Methods: A retrospective cohort study was conducted of 11,034 primiparas delivering at term at the University of California, San Francisco, between 1990 and 2008. We used multivariable analyses to evaluate racial and ethnic differences in risks of, and indications for, cesarean delivery. Results: The overall rate of cesarean delivery in our cohort was 21.9 percent. Black and Latina women were at significantly higher odds of undergoing cesarean delivery than white women (adjusted odds ratio or AOR: 1.54; 95% CI: 1.30, 1.83, and 1.21; 95% CI: 1.03, 1.43, respectively). Black women were at significantly higher odds of undergoing cesarean delivery for nonreassuring fetal heart tracings than white women (AOR: 2.19; 95% CI: 1.55, 3.09), and black women (AOR: 1.55; 95% CI: 1.21, 1.98), Latina women (AOR: 1.48; 95% CI: 1.19, 1.85), and Asian women (AOR: 1.47; 95% CI: 1.22, 1.85) were at significantly higher odds of undergoing cesarean delivery for failure to progress. Black, Latina, and Asian women were at significantly lower odds of undergoing cesarean delivery for malpresentation than white women (AOR: 0.56; 95% CI: 0.34, 0.89, 0.66; 95% CI: 0.44, 0.98, and 0.55; 95% CI: 0.40, 0.76, respectively). Conclusions: Racial and ethnic differences exist in specific indications for cesarean delivery among primiparas. Clarifying the possible reasons for increased cesareans for nonreassuring fetal heart tracing in black women, in particular, may help to decrease excess cesarean deliveries in this racial and ethnic group.
机译：背景：众所周知，美国的黑人和拉丁裔妇女剖宫产的比率高于其他妇女。我们试图探索剖宫产的医学适应症作为这些差异的潜在解释的作用。方法：回顾性队列研究在1990年至2008年期间对加利福尼亚大学旧金山分校足月分娩的11034例初产妇进行了研究。我们使用多变量分析评估了剖宫产的风险和适应症的种族和族裔差异。结果：我们队列中的剖宫产总率为21.9％。黑人和拉丁裔妇女剖宫产的几率明显高于白人妇女（调整后的优势比或AOR：1.54; 95％CI：1.30、1.83和1.21; 95％CI：1.03、1.43）。黑人妇女因无法放心的胎儿心脏描记而进行剖腹产的几率明显高于白人妇女（AOR：2.19; 95％CI：1.55、3.09）和黑人妇女（AOR：1.55; 95％CI：1.21、1.98），拉丁裔妇女（AOR：1.48; 95％CI：1.19，1.85）和亚洲妇女（AOR：1.47; 95％CI：1.22，1.85）因无法进展而接受剖宫产的几率更高。黑人，拉丁裔和亚裔妇女因剖腹产而流产不全的几率大大低于白人妇女（AOR：0.56; 95％CI：0.34、0.89、0.66; 95％CI：0.44、0.98和0.55; 95％CI ：分别为0.40和0.76）。结论：初产妇剖宫产的具体适应症存在种族和种族差异。明确剖析增加剖宫产的可能原因，尤其是黑人妇女无法放心的胎儿心脏描记，可能有助于减少该种族和族裔的剖宫产。

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