Differential rates of cesarean delivery by maternal geographical origin: a cohort study in France

Abstract

Background: In many Western countries, higher rates of cesarean have been described among migrant women compared to natives of receiving countries. We aimed to estimate this difference comparing women originating from France and Sub-Saharan Africa (SSA), identify the clinical situations explaining most of this difference and assess whether maternal origin was independently associated with cesarean risk. Methods: The PreCARE prospective multicenter cohort study was conducted in 2010-2012 in the north Paris area. Our sample was restricted to 1500 women originating from Sub-Saharan Africa and 2206 from France. Profiles of cesarean section by maternal origin were described by the Robson classification. Independent associations between maternal origin and 1) cesarean before labor versus trial of labor, then 2) intrapartum cesarean versus vaginal delivery were assessed by logistic regression models to adjust for other maternal and pregnancy characteristics. Results: Rates of cesarean for women originating from France and SSA were 17 and 31%. The Robson 5A category "unique uterine scar, single cephalic ≥37 weeks" was the main contributor to this difference. Within this category, SSA origin was associated with cesarean before labor after adjustment for medical risk factors (adjusted odds ratio [aOR] = 2.30 [1.12-4.71]) but no more significant when adjusting on social deprivation (aOR = 1.45 [0.63-3.31]). SSA origin was associated with cesarean during labor after adjustment for both medical and social factors (aOR = 2.95 [1.35-6.44]). Conclusions: The wide difference in cesarean rates between SSA and French native women is mainly explained by the Robson 5A category. Within this group, medical factors alone do not explain the increased risk of cesarean in SSA women.

ehealth literacy and health literacy among immigrants and their descendants compared with women of Danish origin: a cross-sectional study using a multidimensional approach among pregnant women

“…[2][3][4] The causes for the adverse outcomes are complex but have been linked to miscommunication and misunderstandings leading to suboptimal quality of maternity care, resulting in poorer outcomes. [5][6][7] There is little knowledge of whether these disparities transfer over generations of women, but findings from Norway and the Netherlands have shown that descendants of immigrants had higher risks of stillbirth than the native populations. 8 9 With the current orientation towards patient-centred care, citizens are expected to have the ability to find and use health information, make decisions and navigate the healthcare system.…”

Pregnancy delivery mode prediction using dichotomous radial basis Tanimoto network

“…Comparative evaluation of DRBTNP method with two existing methods such as multimodal convolutional neural network (MCNN) model designed by Petrozziello et al 2 and Robson classification method introduced by Linard et al 3 are carried out for verifying the effectiveness of the proposed research work during the pregnancy delivery mode prediction. Through the tables and graphs values, the DRBTNP method is evaluated using the following metrics.…”

“…Petrozziello et al 2 implemented Multimodal Convolutional Neural Network (MCNN) model to analyze the big available dataset for predicting the cesarean forceps or ventouse delivery using patient records. Linard et al 3 introduced Robson classification method to forecast the cesarean section or vaginal delivery using logistic regression models. However, the conventional failed to analyze more clinical risk factors for delivery prediction.…”

Effect of sexual dysfunction on women’s preference for delivery methods: a social media-based survey

“…Numerous studies investigated which factors motivate women to opt for C/S [20][21][22][23][24]. The driving forces and causes of C/S are several and vary from country to country and from culture to culture [25,26]. It is important to understand the influencing factors to curb the increase in C/S rates more efficiently.…”