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Mäori and non-Mäori differences in caesarean section rates

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From Māori Health Review Issue 2
Authors:
  • Harris R et al
Summary:

National total, acute and elective caesarean section (CS) rates (as proportions of women giving birth in New Zealand hospitals during 1997-2001) were used to examine relationships between CS, deprivation and ethnicity. Logistic regression analysis was used to adjust for age, deprivation, some clinical factors, and District Health Board. In comparison to Mäori, total, acute and elective rates of CS were significantly higher in non-Mäori women (21 vs 13%; OR 1.59; p < 0.0001 for total CS). Increasing deprivation was correlated with decreasing rates of CS. Differences between Mäori and non-Mäori remained after controlling for age, deprivation and other factors. The authors concluded that although deprivation may contribute to the differences observed, it does not fully explain them, and suggest that further research is warranted.

Comment:
A controversial topic, Harris and colleagues looked at rates of caesarean sections (CS) and showed differences between Mäori and non Mäori for total, elective and acute CS. Non Mäori women were more likely to have CS than Mäori women. Although there is support for the delivery of baby without intervention, we note that CS are necessary in certain circumstances to ensure the best possible outcomes for mother and baby and can prevent maternal and neonatal mortality or morbidity. As the authors suggest, we need to know whether ethnic differences in CS rates are associated with ethnic differences in maternal and neonatal outcomes. Further research is required.
Reference: JNZMA. 2007; 120(1250)
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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