ArticleObstetrics and gynecology2022
Variations in Low-Risk Cesarean Delivery Rates in the United States Using the Society for Maternal-Fetal Medicine Definition.
Article in Obstetrics and gynecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 12 citations in OpenAlex.
- Association Between Racial Segregation of Labor and Delivery Services and Utilization of Trial of Labor and Vaginal Birth After Cesarean.Obstetrics and gynecology · 2026Observational
- Hospital Cesarean Delivery Rankings by Overall, Low-Risk, and Reliability-Adjusted Metrics.JAMA network open · 2026Article
- Predicting Cesarean Section Delivery in the United States Using Machine Learning: Population-Based Retrospective Study.JMIR formative research · 2026Article
- Outcomes of Congenital Heart Disease Deliveries at a Freestanding Children's Hospital.Pediatric cardiology · 2026Article
- Examining Racial and Ethnic Disparities in Low-Risk Cesarean Section Deliveries in the Colorado Healthy Start Study.Journal of racial and ethnic health disparities · 2026Article
- Article
- 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
- Documentation of Stigmatizing Language in Electronic Health Records and Birth Outcomes.Health equity · 2025Article
- Racial disparities in low-risk cesarean birth rates across hospitals.Birth (Berkeley, Calif.) · 2024Article
- Applying the Modified Ten-Group Robson Classification in a Spanish Tertiary Hospital.Journal of clinical medicine · 2023Article
- Cesarean Delivery Trends Among Patients at Low Risk for Cesarean Delivery in the US, 2000-2019.JAMA network open · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess variations in low-risk cesarean delivery rates in the United States using the Society for Maternal-Fetal Medicine (SMFM) definition of low-risk for cesarean delivery and to identify factors associated with low-risk cesarean deliveries.
methodsFrom hospital discharge data in the 2018 National Inpatient Sample and State Inpatient Databases, we identified deliveries that were low-risk for cesarean delivery using the SMFM definition based on the International Classification of Diseases, Tenth Revision, Clinical Modification codes. We estimated national low-risk cesarean delivery rates overall and by patient characteristics, clinically relevant conditions not included in the SMFM definition, and hospital characteristics based on the nationally representative sample of hospital discharges in the National Inpatient Sample. Multivariate logistic regressions were estimated for the national sample to identify factors associated with low-risk cesarean delivery. We reported low-risk cesarean delivery rates for 27 states and the District of Columbia based on the annual state data that represented the universe of hospital discharges from participating states in the State Inpatient Databases.
resultsOf an estimated 3,634,724 deliveries in the 2018 National Inpatient Sample, 2,484,874 low-risk deliveries met inclusion criteria. The national low-risk cesarean delivery rate in 2018 was 14.6% (95% CI 14.4-14.8%). The rates varied widely by state (range 8.9-18.6%). Nationally, maternal age older than 40 years, non-Hispanic Black or Asian race, private insurance as primary payer, admission on weekday, obesity, diabetes, or hypertension, large metropolitan residence, and hospitals of the South census region were associated with low-risk cesarean delivery.
conclusionApproximately one in seven low-risk deliveries was by cesarean in 2018 in the United States using the SMFM definition and the low-risk cesarean delivery rates varied widely by state.
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