Authors:
Von Katterfeld, B.; Li, J.; M; McNamara, B.; Langridge, A. T.
Authors notes:
International Journal of Gynecology and Obstetrics. 2012;116(2):153-7
Keywords:
Elective cesarean, Emergency cesarean, Immigration, Perinatal complications
Abstract
The objective was to determine whether common perinatal complications could explain variation in risk of cesarean among foreign-born and Australian-born women in Western Australia (WA).
Complication prevalence was calculated using the linked records of 208 982 confinements to non-indigenous women in WA between 1998 and 2006. Logistic regression was used to estimate differences in risk of elective cesarean and emergency cesarean compared with vaginal delivery for foreign-born women from different regions.
The most common complications in emergency cesareans were failure to progress (36.7%) and fetal distress (35.7%). The most common complications in elective cesareans were previous cesarean (56.2%) and malpresentation (16.3%). Women from Sub-Saharan Africa, Southeast Asia, and Southern and Central Asia had an increased risk of emergency cesarean compared with Australian-born women (P < 0.05), whereas women from Oceania, North Africa and the Middle East, and Northeast Asia had a decreased likelihood of elective cesarean compared with Australian-born women (P < 0.05).
Complication prevalence varied by maternal region of birth. However, variation in these complications does not completely explain differences in mode of delivery among foreign-born and Australian-born women in WA. Sociocultural factors must be considered in future research and when establishing culturally appropriate guidelines for obstetric staff dealing with foreign-born women.