Cesarean Deliveries for First Time Moms Highest Among African Americans.

Kaiser Permanente Study Shows Racial/Ethnic Disparities in Cesarean Delivery Trends

PASADENA, Calif. -- A study released by Kaiser Permanente indicates that while the rate of cesarean-section (CS) deliveries for first-time moms has continued to increase over the last ten years, there is a disproportionately higher rate of primary c-sections among African-American women. The study, "Racial and Ethnic Disparities in the Trends in Primary Cesarean Delivery based on Indications," published in the October issue of the American Journal of Obstetrics and Gynecology, showed a significant increase in the rates of primary CS in all race/ethnicity groups, but compared to Caucasian women, African-American women had significantly higher rates of primary CS while the increase in rates among Hispanic women was smaller.

"It's also disconcerting to see that there is a wide variation in indication for primary CS by race/ethnicity that cannot be explained by education, smoking during pregnancy, when prenatal care began or maternal age at delivery," notes lead author, Darios Getahun, MD, MPH, researcher at the Kaiser Permanente Department of Research and Evaluation in Pasadena, CA.

"This study underscores the importance of educating expectant women about the potential impact of CS on the outcome of future pregnancies," according to Getahun.

The ten-year surge in the rate of primary cesarean sections led researchers to hypothesize that given the difference in the prevalence of risk factors for CS by race/ethnicity such as breech presentation, shoulder dystocia, fetal distress, and other medical and obstetrical conditions, as well as the number of elective CS, the race or ethnicity of the first time mother might have a bearing on the CS outcome.

This appears to be the first published study to focus on ethnic disparities on primary CS based on indication and its growing trends. Getahun plans to continue this study.

Additional investigators on the study include: Daniel Strickland, PhD, MSPH; Jean M. Lawrence, ScD, MPH, MSSA; Corinna Koebnick, PhD; Steven J. Jacobsen, MD, PhD, from the Department of Research and Evaluation, Kaiser Permanente Southern California; and Michael J. Fassett, MD, from the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, at Kaiser Permanente's West Los Angeles Medical Center.

About the Kaiser Permanente Department of Research and Evaluation

The Department of Research and Evaluation conducts high quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences, and behavioral research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women's and children's health, quality and safety, and pharmacoepidemiology. Located in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit www.kp.org/research.