Evidence map›Paper›PMID 39422829›Full record

Observational studyJournal of racial and ethnic health disparities2025

Spatial and Racial/Ethnic Variation in the Prevalence of Cesarean Delivery in a South Carolina Medical Center.

Jeffrey T Howard, Sam Lawton, Dulaney Wilson, Amartha Gore, Latha Hebbar, Christine Morton, Christopher Goodier, Myrtede Alfred

Abstract readObservational Study
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In one paragraph

Observational study in Journal of racial and ethnic health disparities, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jeffrey T HowardDepartment of Public Health, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78249, USA. jeffrey.howard@utsa.edu.ORCID 0000-0003-4326-6098
Sam LawtonCollege of Public Health Emory University, Atlanta, GA, USA.
Dulaney WilsonDepartment of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.
Amartha GoreChildren's Mercy Hospital, Junction City, KS, USA.
Latha HebbarDepartment of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.
Christine MortonDepartment of Pediatrics and Neonatology, Stanford University, Palo Alto, CA, USA.
Christopher GoodierDepartment of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
Myrtede AlfredDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.

Funding

AHRQ HHS 1R03HS027680-01A1
6 · The paper itself

Abstract

introductionWhile racial/ethnic disparities in cesarean delivery have been noted in the literature, less is known about the intersection between individual-level race/ethnicity and community-level social vulnerability as factors in cesarean delivery. The goal was to use medical record data from a large medical center combined with census tract-level data to examine patterns of social vulnerability, racial population distribution, and prevalence of cesarean delivery.

methodsData were obtained from electronic medical records of patients from a large medical center in South Carolina from 2019 to 2020. The outcome variable was cesarean delivery (yes/no), and covariates included the year of delivery; age of patient; race/ethnicity; spoken language; BMI categories; clinical indications of anemia, hypertension, preeclampsia, and diabetes; and census tract Social Vulnerability Index (SVI). Generalized linear mixed models for multilevel binary logistic regression were used to test the main hypothesis that the census tract level Social Vulnerability Index is positively associated with cesarean delivery.

resultsAmong a total of 5011 patients, we found that non-Hispanic Black mothers were more likely to have cesarean deliveries compared with non-Hispanic White mothers. After controlling for census tract-level SVI, the individual-level race/ethnicity association was no longer significant. Significant spatial autocorrelation across census tracts was evident for cesarean delivery prevalence, non-Hispanic Black population, and SVI. A high prevalence of cesarean delivery tended to cluster with high SVI and a high non-Hispanic Black population.

conclusionsWe found that non-Hispanic Black mothers were more likely to have cesarean deliveries, which was explained by census tract differences in the SVI.

Indexed as

Cesarean SectionEthnicityHealthcare DisparitiesRacial GroupsAdultBlack or African AmericanFemaleHumansPregnancyPrevalenceSouth CarolinaWhiteYoung AdultCesarean deliveryHealth disparitiesMaternal healthMaternal morbiditySpatial analysis

Identifiers

PMID39422829

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