ArticleBMC pregnancy and childbirth2013
Racial and ethnic differences in primary, unscheduled cesarean deliveries among low-risk primiparous women at an academic medical center: a retrospective cohort study.
Article in BMC pregnancy and childbirth, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- Systems Factors Contributing to Racial/Ethnic Disparities in Maternal Health: A Systematic Review.Journal of racial and ethnic health disparities · 2026Pooled it
- The Safety of Low-Dose Aspirin on the Mode of Delivery: Secondary Analysis of the Effect of Aspirin in Gestation and Reproduction Randomized Controlled Trial.American journal of perinatology · 2022Trial
- Racial/Ethnic Differences in Labor Outcomes with Prostaglandin Vaginal Inserts.Journal of racial and ethnic health disparities · 2015Trial
- The Association Between Experiencing Racial Discrimination and Delivery Method Among Women in the United States, PRAMS 2016-2021.Journal of racial and ethnic health disparities · 2026Article
- Predicting Cesarean Section Delivery in the United States Using Machine Learning: Population-Based Retrospective Study.JMIR formative research · 2026Article
- Can Birth Hospital Explain Racial/Ethnic Differences in Cesarean Birth Among Low-Risk Births? An Analysis of California Data, 2007-2018.Journal of racial and ethnic health disparities · 2026Article
- Racial and Ethnic Disparities in Low-Risk Unplanned Cesarean Birth: Disaggregating Asian Data.Journal of racial and ethnic health disparities · 2026Article
- Retrospective Cohort Study on Racial and Ethnic Disparities in Cesarean Birth in a Midwifery-Integrated Health System.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2026Article
- Optimal Timing of Term Births by Maternal Region of Birth: Elective Induction of Labor Compared to Expectant Management in Victoria, Australia.Birth (Berkeley, Calif.) · 2026Article
- Low-risk Cesareans Across the US: A Decomposition of Individual- and County-level Factors by Race/Ethnicity.Journal of racial and ethnic health disparities · 2026Article
- Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery.Birth (Berkeley, Calif.) · 2025Article
- Evaluating rates and factors associated with cesarean section and inpatient cost among low-risk deliveries in selected U.S. states.BMC pregnancy and childbirth · 2025Article
- Socioeconomic disadvantage and racial/ethnic disparities in low-risk cesarean birth in California.American journal of epidemiology · 2025Article
- Obstructed Labor, Evolution, and Health Disparities.Biology · 2024Review
- Differences in maternal and perinatal outcomes between Dutch and non-Western women in a midwife-led care setting: a retrospective cohort study.BMC pregnancy and childbirth · 2024Article
- Impact of Race/Ethnicity and Insurance Status on Obstetric Outcomes: Secondary Analysis of the NuMoM2b Study.American journal of perinatology · 2024Article
- The use of bubble charts in analyzing the global second-stage cesarean delivery rates: a systematic review.AJOG global reports · 2024Review
- Article
- Association of Maternal Comorbidity Burden With Cesarean Birth Rate Among Nulliparous, Term, Singleton, Vertex Pregnancies.JAMA network open · 2023Article
- Health Disparities in the Use of Primary Cesarean Delivery among Asian American Women.International journal of environmental research and public health · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCesarean sections are the most common surgical procedure for women in the United States. Of the over 4 million births a year, one in three are now delivered in this manner and the risk adjusted prevalence rates appear to vary by race and ethnicity. However, data from individual studies provides limited or contradictory information on race and ethnicity as an independent predictor of delivery mode, precluding accurate generalizations. This study sought to assess the extent to which primary, unscheduled cesarean deliveries and their indications vary by race/ethnicity in one academic medical center.
methodsA retrospective, cross-sectional cohort study was conducted of 4,483 nulliparous women with term, singleton, and vertex presentation deliveries at a major academic medical center between 2006-2011. Cases with medical conditions, risk factors, or pregnancy complications that can contribute to increased cesarean risk or contraindicate vaginal birth were excluded. Multinomial logistic regression analysis was used to evaluate differences in delivery mode and caesarean indications among racial and ethnic groups.
resultsThe overall rate of cesarean delivery in our cohort was 16.7%. Compared to White women, Black and Asian women had higher rates of cesarean delivery than spontaneous vaginal delivery, (adjusted odds ratio {AOR}: 1.43; 95% CI: 1.07, 1.91, and AOR: 1.49; 95% CI: 1.02, 2.17, respectively). Black women were also more likely, compared to White women, to undergo cesarean for fetal distress and indications diagnosed in the first stage as compared to the second stage of labor.
conclusionsRacial and ethnic differences in delivery mode and indications for cesareans exist among low-risk nulliparas at our institution. These differences may be best explained by examining the variation in clinical decisions that indicate fetal distress and failure to progress at the hospital-level.
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