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01-09-2016

Comparison of Primary Cesarean Delivery Rates Among Low-Risk Women in Urban and Rural Hospitals in Hawaii

Authors: Ann Lee Chang, Misty Pacheco, Kurt Yoshino, Jill Miyamura, Jay Maddock

Published in: Maternal and Child Health Journal | Issue 9/2016

Abstract

Objective The purpose of this study was to examine primary cesarean delivery rates among women with low risk pregnancies in urban and rural hospitals in Hawaii. Methods This is a retrospective study of all low-risk women (term, vertex, singleton) who had a primary cesarean delivery in any Hawaii hospital from 2010 to 2011 using a statewide health information database. Hospitals were divided into two categories: rural and urban. Results Of the 27,096 women who met criteria for this study, 7105 (26.2 %) delivered in a rural hospital. Low-risk women who delivered in a rural hospital had a primary cesarean delivery rate of 18.5 % compared to 11.8 % in the urban hospitals, p < .0001. Low-risk women who delivered at rural hospitals had significantly higher unadjusted and adjusted odds ratios for cesarean delivery. The association with rural hospital was stronger after adjusting for confounders, aOR 2.47 (95 % CI 2.23–2.73) compared to unadjusted OR 1.70 (95 % CI 1.58–1.83) for primary cesarean delivery. Conclusions on practice In a geographically isolated population, rates of primary cesarean delivery among low-risk women are significantly higher in rural hospitals. This disparity should be investigated further.

American College of Obstetrics and Gynecologists, Women Health Care Physicians. (2015). Frequently asked questions labor, delivery, and postpartum care FAQ006. Retreived from, http://www.acog.org/~/media/For%20Patients/faq006.pdfa.

American College of Obstetricians and Gynecologists (College), Society for Maternal-Fetal Medicine, Caughey, A. B., Cahill, A. G., Guise, J. M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. American Journal of Obstetrics and Gynecology. doi:10.1016/j.ajog.2014.01.026.

Cheng, Y. W., Snowden, J. M., Handler, S., Tager, I. B., Hubbard, A., & Caughey, A. B. (2013). Clinicians’ practice environment is associated with a higher likelihood of recommending cesarean deliveries. Journal of Maternal-Fetal and Neonatal Medicine. doi:10.3109/14767058.2013.860440.PubMedCentral

Clark, E. A. S., & Silver, R. M. (2011). Long-term maternal morbidity associated with repeat cesarean delivery. American Journal of Obstetrics and Gynecology, 205(6), S2–S10.CrossRefPubMed

Greene, S.B., Holmes, G.M., Slifkin, R., Freeman, V., & Howard, H.A. (2004). Cesarean delivery patterns in rural hospitals. Retrieved from, http://www.shepscenter.unc.edu/research_programs/rural_program/FB79.pdf.

Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2011). Births: Preliminary data for 2010. National Vital Statistics Reports, 60(2), 1–72.PubMed

Kozhimannil, K. B., Hung, P., Prasad, S., Casey, M., & Moscovice, I. (2014). Rural-urban differences in obstetrics care, 2002–2010, and implications for the future. Medical Care, 52(1), 4–9.CrossRefPubMedPubMedCentral

Osterman, M. J. K., & Martin, J. A. (2014). Trends in low-risk cesarean delivery in the United States, 1990–2013. National Vital Statistics Report, 63(6), 1–16.

Sieck, C. (1997). Vaginal birth after cesarean section: A comparison of rural and metropolitan rates in Oklahoma. Journal of the Oklahoma State Medical Association, 90(8), 444–449.PubMed

10.

The Joint Commission. (2009). NQF-Endorsed voluntary consensus standards for hospital care measure information form. Retrieved from, https://manual.jointcommission.org/releases/archive/TJC2010A/MIF0167.html.

11.

Truven Health Analytics. (2013). The cost of having a baby in the United States. Retrieved from, http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby1.pdf.

12.

U.S. Census Bureau. (2014). 2014 Population estimate summary data. Retrieved from, http://files.hawaii.gov/dbedt/census/popestimate/2014_state_pop_hi/2014_popest_sumtab.pdf.

13.

U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (2014). Healthy People 2020. Retrieved from, http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

14.

Yasmeen, S., Sl, Romano P., El, Schembri M., Keyzer, J. M., & Gilbert, W. M. (2006). Accuracy of obstetric diagnoses and procedures in hospital discharge data. American Journal of Obstetrics and Gynecology, 194(4), 992–1001.CrossRefPubMed

Title: Comparison of Primary Cesarean Delivery Rates Among Low-Risk Women in Urban and Rural Hospitals in Hawaii
Authors: Ann Lee Chang
Misty Pacheco
Kurt Yoshino
Jill Miyamura
Jay Maddock
Publication date: 01-09-2016
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 9/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-2012-2

At a glance: The STEP trials

Springer Medicine

Comparison of Primary Cesarean Delivery Rates Among Low-Risk Women in Urban and Rural Hospitals in Hawaii

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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