ArticleObstetrics and gynecology2022
Racial and Ethnic Disparities in Primary Cesarean Birth and Adverse Outcomes Among Low-Risk Nulliparous People.
Article in Obstetrics and gynecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers.
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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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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- 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
- 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
- Cesarean Section Rates and Mobile Health's Role in Equitable Access to Prenatal Care.International journal of environmental research and public health · 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 and Ethnic Disparities in Cesarean Birth Trends in the United States.JAMA network open · 2025Observational
- The first 1000 days: the price of inequalities in high and middle-income countries.Pediatric research · 2025Review
- Neonatal and maternal adverse outcomes among low-risk nulliparous women compared with multiparous women at 37-41 weeks of gestation: a cohort study in South China.Frontiers in medicine · 2025Article
- Are Racial Disparities in Cesarean Due to Differences in Labor Induction Management?American journal of perinatology · 2024Article
- 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
- Racial and Ethnic Disparities in Primary Cesarean Birth and Adverse Outcomes Among Low-Risk Nulliparous People.Obstetrics and gynecology · 2023Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo compare trend of primary cesarean delivery rate and composite neonatal and maternal adverse outcomes in low-risk pregnancies among racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic.
methodsThis population-based cohort study used U.S. vital statistics data (2015-2019) to evaluate low-risk, nulliparous patients with nonanomalous singletons who labored and delivered at 37-41 weeks of gestation. The primary outcome was the primary cesarean delivery rate. Secondary outcomes included composite neonatal adverse outcome (Apgar score less than 5 at 5 minutes, assisted ventilation for more than 6 hours, seizure, or death), and composite maternal adverse outcome (intensive care unit admission, blood transfusion, uterine rupture, or unplanned hysterectomy), as well as infant death. Multivariable Poisson regression models were used to estimate adjusted relative risks (aRR) and 95% CIs.
resultsAmong 4.3 million births, 60.6% identified as non-Hispanic White, 14.6% identified as non-Hispanic Black, and 24.8% identified as Hispanic. The rate of primary cesarean delivery was 18.5% (n=804,155). An increased risk for cesarean delivery was found in non-Hispanic Black (21.7%, aRR 1.24, 95% CI 1.23-1.25) and Hispanic (17.3%, aRR 1.09, 95% CI 1.09-1.10) individuals, compared with non-Hispanic White individuals (18.1%) after multivariable adjustment. There was an upward trend in the rate of primary cesarean delivery in all racial and ethnic groups ( P for linear trend<0.001 for all groups). However, the racial and ethnic disparity in the rate of primary cesarean delivery remained stable during the study period. The composite neonatal adverse outcome was lower in Hispanic individuals in all newborns (10.7 vs 8.3 per 1,000 live births, aRR 0.74, 95% CI 0.72-0.75), and in newborns delivered by primary cesarean delivery (18.5 vs 15.0 per 1,000 live births, aRR 0.73, 95% CI 0.70-0.76), compared with non-Hispanic White individuals.
conclusionUsing a nationally representative sample in the United States, we found racial and ethnic disparities in the primary cesarean delivery rate in low-risk nulliparous patients, which persisted throughout the study period.
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