For a study, researchers sought to examine the main cesarean delivery rate trend and the composite of newborn and maternal unfavorable outcomes in low-risk pregnancies among the non-Hispanic White, non-Hispanic Black, and Hispanic racial and ethnic groups.
The population-based cohort study examined low-risk nulliparous women who gave birth to nonanomalous singletons at 37–41 weeks of gestation and experienced labor and delivery using U.S. vital statistics data (2015–2019). The primary cesarean birth rate was the main result. In addition to infant mortality, secondary outcomes included composite maternal adverse outcomes (intensive care unit admission, blood transfusion, uterine rupture, or unplanned hysterectomy), as well as composite neonatal adverse outcome (Apgar score less than 5 at 5 minutes, assisted ventilation for more than 6 hours, seizure, or death). Adjusted relative risks (aRR) and 95% CIs were estimated using multivariable Poisson regression models.
In 4.3 million births, 60.6% of the population was classified as non-Hispanic White, 14.6% as non-Hispanic Black, and 24.8% as Hispanic. Primary cesarean birth rates were 18.5% (n=804,155). Compared to non-Hispanic White people (18.1%), non-Hispanic Black people (21.7%, aRR 1.24, 95% CI 1.23-1.25), and Hispanic people (17.3%, aRR 1.09, 95% CI 1.09-1.10) had a higher chance of having a cesarean birth. In all racial and ethnic groupings, the prevalence of primary cesarean deliveries increased (P for linear trend <0.001 for all categories). However, the rate of primary cesarean deliveries continued to differ according to race and ethnicity throughout the research period. Comparing Hispanic people to non-Hispanic White people, the composite neonatal adverse outcome was lower in all newborns (10.7 vs. 8.3 per 1,000 live births, aRR 0.74, 95% CI 0.72-0.75) and newborns delivered by primary cesarean delivery (18.5 vs. 15.0 per 1,000 live births, aRR 0.73, 95% CI 0.70-0.76).
They discovered racial and ethnic discrepancies in the main cesarean delivery rate in low-risk nulliparous patients using a nationally representative sample in the United States, and the differences persisted over the course of the research.