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Disparities in Labor Management Strategies for CD

Obstet Gynecol; ePub 2017 Nov 3; Yee, et al

Differential use of labor management strategies intended to reduce cesarean delivery (CD) rates do not appear to be associated with racial and ethnic disparities, a recent study found. The secondary analysis included women at term with singleton, nonanomalous, vertex, liveborn neonates who were included in 2 cohorts: 1) nulliparous women and 2) multiparous women with prior vaginal deliveries only. Women were grouped as non-Hispanic black, non-Hispanic white, Hispanic, and Asian. Study details included:

  • 75,400 women were eligible for inclusion (47% in the nulliparous cohort and 53% in the multiparous cohort).
  • For nulliparous women, unadjusted CD frequencies were 25.0%, 28.3%, 28.7%, and 24.0% for non-Hispanic white, non-Hispanic black, Asian, and Hispanic women, respectively.
  • Among nulliparous women, the adjusted odds of CD were higher in all racial and ethnic groups compared with non-Hispanic white women.
  • Nonapplication of labor management strategies regarding failed induction, arrest of dilation, arrest of descent, or cervical ripening did not contribute to increased odds of CD for non-Hispanic black and Hispanic women.
  • Similar trends were seen among multiparous women with prior vaginal deliveries.

Citation:

Yee LM, Constantine MM, Rice MM, et al. Racial and ethnic differences in utilization of labor management strategies intended to reduce cesarean delivery rates. [Published online ahead of print November 3, 2017]. Obstet Gynecol. doi:10.1097/AOG.0000000000002343.