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BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Cesarean and VBAC rates among immigrant vs. native-born women: a retrospective observational study from Taiwan Cesarean delivery and VBAC among immigrant women in Taiwan

Authors: Jung-Chung Fu, Sudha Xirasagar, Jihong Liu, Janice C Probst

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Cultural and ethnic roots impact women's fertility and delivery preferences This study investigated whether the likelihood of cesarean delivery, primary cesarean, and vaginal delivery after cesarean (VBAC) varies by maternal national origin.

Methods

We conducted a nation-wide, population-based, observational study using secondary data from Taiwan. De-identified data were obtained on all 392,246 singleton live births (≥500 g; ≥20 weeks) born to native-born Taiwanese, Vietnamese and mainland Chinese-born mothers between January 1 2006 and December 31 2007 from Taiwan's nation-wide birth certificate data. Our analytic samples consisted of the following: for overall cesarean likelihood 392,246 births, primary cesarean 336,766 (excluding repeat cesarean and VBAC), and VBAC 55,480 births (excluding primary cesarean and vaginal births without previous cesarean). Our main outcome measures were the odds of cesarean delivery, primary cesarean delivery and VBAC for Vietnamese and Chinese immigrant mothers relative to Taiwanese mothers, using multiple regression analyses to adjust for maternal and neonatal characteristics, paternal age, institutional setting, and major obstetric complications.

Results

Unadjusted overall cesarean, primary cesarean, and VBAC rates were 33.9%, 23.0% and 4.0% for Taiwanese, 27.6%, 20.1% and 5.0% for mainland Chinese, and 19.3%, 13.9 and 6.1% for Vietnamese respectively. Adjusted for confounders, Vietnamese mothers were less likely than native-born Taiwanese to have overall and primary cesarean delivery (OR = 0.59 and 0.58 respectively), followed by Chinese mothers (both ORs = 0.90 relative to native-born Taiwanese). Vietnamese mothers were most likely to have successful VBAC (OR = 1.58), followed by Chinese mothers (OR = 1.25).

Conclusion

Immigrant Vietnamese and Chinese mothers have lower odds of cesarean and higher VBAC odds than native-born Taiwanese, consistent with lower cesarean rates prevailing in their home countries (Vietnam 10.1%; mainland China 20% - 50% rural and urban respectively).
Literature
1.
2.
3.
4.
5.
6.
Liao CC, Chan WY: Concerns Over the Life and Health of Alien Brides from Southeastern Asia and Mainland China. Tzu Chi Nursing Journal. 2005, 4 (1): 12-6.
7.
Wang HH, Yang YM: Women Health of Southeast Asian Cross Country Marriage. Journal of Nursing Research. 2002, 49: 35-41.
8.
9.
Hsu CY, Lo JC, Chang JH, Chen CP, Yu S, Huang FY: Cesarean births in Taiwan. Int J Gynaecol Obstet. 2007, 96 (1): 57-61. 10.1016/j.ijgo.2006.09.011.CrossRefPubMed
10.
Lin HC, Xirasagar S: Institutional factors in cesarean delivery rates: policy and research implications. Obstet Gynecol. 2004, 103 (1): 128-36. 10.1097/01.AOG.0000102935.91389.53.CrossRefPubMed
11.
12.
Rosen T: Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate. Clin Perinatol. 2008, 35: 519-29. 10.1016/j.clp.2008.07.003.CrossRefPubMed
13.
Bettegowda V, Dias T, Davidoff M, Damus K, Callaghan W, Petrini J: The relationship between cesarean delivery and gestational age among US singleton births. Clin Perinatol. 2008, 35: 309-23. 10.1016/j.clp.2008.03.002.CrossRefPubMed
14.
Miller JJ: Maternal and neonatal morbidity and mortality in cesarean section. Obstet Gynecol Clin North Am. 1988, 15: 629-38.PubMed
15.
Hook B, Kiwi R, Amini SB, Fanaroff A, Hack M: Neonatal morbidity after elective repeat cesarean section and trial of labor. Pediatrics. 1997, 100 (3 Pt 1): 348-53. 10.1542/peds.100.3.348.CrossRefPubMed
16.
Belizan JM, Althabe F, Barros FC, Alexander S: Rates and implications of caesarean sections in Latin America: ecological study. BMJ. 1999, 319 (7222): 1397-400.CrossRefPubMedPubMedCentral
17.
Betran AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, Wagner M: Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007, 21 (2): 98-113. 10.1111/j.1365-3016.2007.00786.x.CrossRefPubMed
18.
Merten S, Wyss C, Ackermann-Liebrich U: Caesarean sections and breastfeeding initiation among migrants in Switzerland. Int J Public Health. 2007, 52 (4): 210-22. 10.1007/s00038-007-6035-8.CrossRefPubMed
19.
Vangen S, Stoltenberg C, Skrondal A, Magnus PER, Stray-Pedersen B: Cesarean section among immigrants in Norway. Acta Obstetricia et Gynecologica Scandinavica. 2000, 79 (7): 553-8. 10.1080/j.1600-0412.2000.079007553.x.CrossRefPubMed
20.
Murray SF: Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study. BMJ. 2000, 321 (7275): 1501-5. 10.1136/bmj.321.7275.1501.CrossRefPubMedPubMedCentral
21.
Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodonico L, Bataglia V, Faundes A, Langer A, Narvaez A, Donner A, Romero M, Reynoso S, de Padua KS, Giordano D, Kublickas M, Acosta A: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006, 367 (9525): 1819-29. 10.1016/S0140-6736(06)68704-7.CrossRefPubMed
22.
Hong X: Factors related to the high cesarean section rate and their effects on the "price transparency policy" in Beijing, China. Tohoku J Exp Med. 2007, 212 (3): 283-98. 10.1620/tjem.212.283.CrossRefPubMed
23.
Zhang J, Liu Y, Meikle S, Zheng J, Sun W, Li Z: Cesarean delivery on maternal request in southeast China. Obstet Gynecol. 2008, 111 (5): 1077-82. 10.1097/AOG.0b013e31816e349e.CrossRefPubMed
24.
Chen CS, Lin HC, Liu TC, Lin SY, Pfeiffer S: Urbanization and the likelihood of a cesarean section. Eur J Obstet Gynecol Reprod Biol. 2008, 141 (2): 104-10. 10.1016/j.ejogrb.2008.07.016.CrossRefPubMed
25.
Baicker K, Buckles KS, Chandra A: Geographic variation in the appropriate use of cesarean delivery. Health Aff (Millwood). 2006, 25 (5): w355-67. 10.1377/hlthaff.25.w355.CrossRef
26.
Li YR, Shen PY, Liao MH, Lin YP: Exploration of the demographic characteristics of marital immigrants in Taiwan and its public health needs. Taiwan J Public Health. 2006, 25 (6): 482-93.
27.
Tang CH, Wu MP, Liu JT, Lin HC, Hsu CC: Delayed Parenthood and the Risk of Cesarean Delivery-Is Paternal Age an Independent Risk Factor?. Birth: Issues in Perinatal Care. 2006, 33 (1): 18-26.CrossRef
28.
Shuei JT: Evolution of marriage in Taiwan and social impact. National policy forum. 2003, 7: 255-9.
29.
Gould JB, Davey B, Stafford RS: Socioeconomic differences in rates of cesarean section. N Engl J Med. 1989, 321 (4): 233-9. 10.1056/NEJM198907273210406.CrossRefPubMed
30.
Barros FC, Vaughan JP, Victora CG, Huttly SR: Epidemic of caesarean sections in Brazil. Lancet. 1991, 338 (8760): 167-9. 10.1016/0140-6736(91)90149-J.CrossRefPubMed
31.
Haas JS, Udvarhelyi S, Epstein AM: The effect of health coverage for uninsured pregnant women on maternal health and the use of cesarean section. JAMA. 1993, 270 (1): 61-4. 10.1001/jama.270.1.61.CrossRefPubMed
32.
Lin HC, Xirasagar S: Maternal age and the likelihood of a maternal request for cesarean delivery: A 5-year population-based study. Am J Obstet Gynecol. 2005, B: 848-55. 10.1016/j.ajog.2004.09.133.CrossRef
33.
Tranquilli AL, Giannubilo SR: Cesarean delivery on maternal request in Italy. Int J Gynaecol Obstet. 2004, 84 (2): 169-70. 10.1016/S0020-7292(03)00319-9.CrossRefPubMed
34.
Irvine LM, Shaw RW: Trial of scar or elective repeat caesarean section at maternal request?. J Obstet Gynaecol. 2001, 21 (5): 463-7. 10.1080/01443610120071992.CrossRefPubMed
35.
Kolas T, Hofoss D, Daltveit AK, Nilsen ST, Henriksen T, Hager R, Ingemarsson I, Oian P: Indications for cesarean deliveries in Norway. Am J Obstet Gynecol. 2003, 188 (4): 864-70. 10.1067/mob.2003.217.CrossRefPubMed
36.
Gyamfi C, Juhasz G, Gyamfi P, Stone JL: Racial disparities and VBAC success rates. Am J Obstet Gynecol. 2005, 193 (6, Supplement 1): S179-S. 10.1016/j.ajog.2005.10.722.CrossRef
37.
McMahon MJ, Luther ER, Bowes WA, Olshan AF: Comparison of a trial of labor with an elective second cesarean section. N Engl J Med. 1996, 335 (10): 689-95. 10.1056/NEJM199609053351001.CrossRefPubMed
38.
Martin J, Hamilton B, Sutton P, Menacker F, Kirmeyer S, Munson ML: Births: Final Data for 2005. National Center for Health Statistics. 2007, 56 (6):
39.
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, Mathews TJ: Births: Final Data for 2006. National Vital Statistics Reports. 2009, 57 (7):
40.
Agency for Healthcare Research and Quality: Vaginal Birth After Cesarean: New Insights Evidence Reports/Technology Assessments, No. 191 Investigator Team: Jeanne-Marie Guise, Karen Eden, Cathy Emeis, Mary Anna Denman, Nicole Marshall, Rongwei (Rochelle) Fu, Rosalind Janik, Peggy Nygren, Miranda Walker, and Marian McDonagh. 2010, Oregon Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon Rockville, MD, USA, Publication No:10-E001
41.
42.
Acevedo-Garcia D, Soobader MJ, Berkman LF: Low birthweight among US Hispanic/Latino subgroups: the effect of maternal foreign-born status and education. Soc Sci Med. 2007, 65 (12): 2503-16. 10.1016/j.socscimed.2007.06.033.CrossRefPubMed
43.
Cesaroni , Forastiere , Perucci : Are Cesarean Deliveries More Likely for Poorly Educated Parents? A Brief Report from Italy. Birth: Issues in Perinatal Care. 2008, 35 (3): 241-244.CrossRef
44.
Czukerberg , Lampley , Blankstein : Obesity at delivery and risk of cesarean section: A ten-year experience. Int J Gynaecol Obstet. 2000, 70: 86-10.1016/S0020-7292(00)80595-0.CrossRef
45.
Hopkins K: Are Brazilian women really choosing to deliver by cesarean?. Soc Sci Med. 2000, 51 (5): 725-40. 10.1016/S0277-9536(99)00480-3.CrossRefPubMed
46.
Hu Y: A prediction of the trend of population development in urban and rural areas in China. Chin J Popul Sci. 1998, 10 (1): 75-87.PubMed
47.
Li S, Wang W: The difference in fertility between urban and rural areas and its impact on the process of urbanization. Chin J Popul Sci. 1994, 6 (2): 201-10.PubMed
48.
Xirasagar S, Lin HC, Liu TC: Do group practices have lower caesarean rates than solo practice obstetric clinics? Evidence from Taiwan. Health Policy Plan. 2006, 21 (4): 319-25. 10.1093/heapol/czl015.CrossRefPubMed
49.
Weaver JJ, Statham H, Richards M: Are There "Unnecessary" Cesarean Sections? Perceptions of Women and Obstetricians About Cesarean Sections for Nonclinical Indications. Birth. 2007, 34 (1): 32-41. 10.1111/j.1523-536X.2006.00144.x.CrossRefPubMed
50.
Pritchard JA, MacDonald PC, Gant NF: Dystocia Caused by Abnormalities in Presentation, Position, or Development of the Fetus. 1985, East Norwalk, Connecticut: Appleton-Century-Crofts, 17
51.
Cho Y, Hummer RA: Disability status differentials across fifteen Asian and Pacific Islander groups and the effect of nativity and duration of residence in the U.S. Soc Biol. 2001, 48 (3-4): 171-95.PubMed
52.
Frisbie WP, Echevarria S, Hummer RA: Prenatal Care Utilization Among Non-Hispanic Whites, African Americans, and Mexican Americans. Matern Child Health J. 2001, 5 (1): 21-10.1023/A:1011393717603.CrossRefPubMed
53.
Hung TH: Advanced Maternal Age and Adverse Perinatal Outcome: A Call for Investigations on Asian Women. Taiwanese Journal of Obstetrics and Gynecology. 2008, 47 (3): 257-8. 10.1016/S1028-4559(08)60121-7.CrossRefPubMed
54.
David RJ: The quality and completeness of birthweight and gestational age data in computerized birth files. Am J Public Health. 1980, 70 (9): 964-73. 10.2105/AJPH.70.9.964.CrossRefPubMedPubMedCentral
55.
Frost F, Starzyk P, George S, McLaughlin JF: Birth complication reporting: the effect of birth certificate design. Am J Public Health. 1984, 74 (5): 505-6. 10.2105/AJPH.74.5.505.CrossRefPubMedPubMedCentral
Metadata
Title
Cesarean and VBAC rates among immigrant vs. native-born women: a retrospective observational study from Taiwan Cesarean delivery and VBAC among immigrant women in Taiwan
Authors
Jung-Chung Fu
Sudha Xirasagar
Jihong Liu
Janice C Probst
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-548

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