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Ethnicity and risk of Caesarean section in a term, nulliparous New Zealand obstetric cohort

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From Māori Health Review Issue 43
Authors:
  • Anderson NH et al
Summary:

These researchers examined ethnicity as an independent risk factor for elective and emergency Caesarean section in nulliparous women at term, in this retrospective analysis of maternity data comprising 11,848 singleton, nulliparous, term births at National Women’s Health, Auckland, from 2006 to 2009. The overall Caesarean section rate was 31.2% (elective 7.8%, n=923 and emergency 23.4%, n=2770). In multivariable logistic regression analysis, comparisons with European women revealed a lower likelihood of elective Caesarean section among Pacific and Chinese women (adjusted odds ratios of 0.42 and 0.68, respectively) and a higher likelihood of emergency Caesarean section among Indian women (aOR 1.54). Rates of elective or emergency Caesarean section for other ethnicities were similar to rates in Europeans.

Comment:
I’d also be interested to see the outcomes associated with ‘equal rates’ of this particular intervention. Many have raised concerns that the higher perinatal and maternal mortality rates for Māori compared with non-Māori may be associated with an inadequate number or quality of surgical intervention.
Reference: Aust N Z J Obstet Gynaecol 2013 Jan 24. [Epub ahead of print]
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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