TITLE

The influence of both individual and area based socioeconomic status on temporal trends in Caesarean sections in Scotland 1980-2000

AUTHOR(S)
Fairley, Lesley; Dundas, Ruth; Leyland, Alastair H.
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011 Supplement 4, Vol. 11 Issue Suppl 4, p330
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Caesarean section rates have risen over the last 20 years. Elective Caesarean section rates have been shown to be linked to area deprivation in England, women in the most deprived areas were less likely to have an elective section than those in the most affluent areas. We examine whether individual social class, area deprivation or both are related to Caesarean sections in Scotland and investigate changes over time. Methods: Routine maternity discharge data from live singleton births in Scottish hospitals from three time periods were used; 1980-81 (n = 133,555), 1990-91 (n = 128,933) and 1999-2000 (n = 102,285). Multilevel logistic regression, with 3 levels (births, postcode sector and Health Board) was used to analyse emergency and elective Caesareans separately; analysis was further stratified by previous Caesarean section. The relative index of inequality (RII) was used to assess socioeconomic inequalities. Results: Between 1980-81 and 1999-2000 the emergency section rate increased from 6.3% to 11.9% and the elective rate from 3.6% to 5.5%. In 1980-81 and 1990-91 emergency Caesareans were more likely among women at the bottom of the social class hierarchy compared to those at the top (RII = 1.14, 95%CI 1.00-1.25 and RII = 1.13, 1.03-1.23 respectively) and also among women in the most deprived areas compared to those in the most affluent (RII = 1.18, 1.05-1.32 and RII = 1.13, 1.02-1.26 respectively). In 1999-2000 the odds of an elective section were lower for women at the bottom of the social class hierarchy than those at the top (RII = 0.87, 0.76-1.00) and also lower in women in the most deprived areas compared to those in the most affluent (RII = 0.85, 0.73-0.99). Conclusions: Both individual social class and area deprivation are independently associated with Caesarean sections in Scotland. The tendency for disadvantaged women to be more likely to receive emergency sections disappeared at the same time as the likelihood of advantaged groups receiving elective sections increased.
ACCESSION #
62664055

 

Related Articles

  • Peripartum hysterectomy in 38 hospitals in China: a population-based study. Wei, Qiang; Zhang, Weiyuan; Chen, Meng; Zhang, Li; He, Guolin; Liu, Xinghui // Archives of Gynecology & Obstetrics;Mar2014, Vol. 289 Issue 3, p549 

    Objective: To investigate the incidence, indications, risk factors and transfusions of peripartum hysterectomy in China. Methods: A population-based study was conducted using inpatient records of 38 hospitals between 1 January 2011 and 31 December 2011; multivariate logistic regression analysis...

  • Appropriateness of Cesarean Sections using the RAND Appropriateness Method Criteria. Ostovar, Rahim; Pourreza, Abolghasem; Rashidian, Arash; Rashidi, Batool Hossein; Hantooshzadeh, Sedigheh; Haghollai, Fedyeh; Ardebili, Hasan Eftekhar; Mahmoudi, Mahmoud // Archives of Iranian Medicine (AIM);Jan2012, Vol. 15 Issue 1, p8 

    Background: The aim of this study was to identify the appropriateness of cesarean sections, performed in Tehran hospitals using standardized Rand Appropriateness Method (RAM) criteria. Methods: In this study we used the RAM criteria. In order to prepare the list of cesarean scenarios, clinical...

  • Hospital Differences in Cesarean Deliveries in Massachusetts (US) 2004–2006: The Case against Case-Mix Artifact. Cáceres, Isabel A.; Arcaya, Mariana; Declercq, Eugene; Belanoff, Candice M.; Janakiraman, Vanitha; Cohen, Bruce; Ecker, Jeffrey; Smith, Lauren A.; Subramanian, S. V. // PLoS ONE;Mar2013, Vol. 8 Issue 3, p1 

    Objective: We examined the extent to which differences in hospital-level cesarean delivery rates in Massachusetts were attributable to hospital-level, rather than maternal, characteristics. Methods: Birth certificate and maternal in-patient hospital discharge records for 2004–06 in...

  • National Health Insurance, Physician Financial Incentives, and Primary Cesarean Deliveries in Taiwan. Yi-Wen Tsai; Teh-Wei Hu // American Journal of Public Health;Sep2002, Vol. 92 Issue 9, p1514 

    Objectives. Taiwan's National Health Insurance Program (NHI) was implemented on March 1, 1995. This study analyzed the influences of the Case Payment method of reimbursement for inpatient care and of physician financial incentives on a woman's choice for primary cesarean delivery. Methods....

  • Does the presence of a Caesarean section scar affect implantation site and early pregnancy outcome in women attending an early pregnancy assessment unit? Naji, O.; Wynants, L.; Smith, A.; Abdallah, Y.; Saso, S.; Stalder, C.; Van Huffel, S.; Ghaem-Maghami, S.; Van Calster, B.; Timmerman, D.; Bourne, T. // Human Reproduction;Jun2013, Vol. 28 Issue 6, p1489 

    STUDY QUESTION Are there any differences in the location and distance to the internal cervical ostium of the implantation site of the intrauterine gestation sacs, early pregnancy symptoms and pregnancy outcome at 12 weeks gestation between women with and without a previous Caesarean section...

  • Caesarean section rates in immigrant and native women in Spain: the importance of geographical origin and type of hospital for delivery. Río, Isabel; Castelló, Adela; Barona, Carmen; Jané, Mireia; Más, Rosa; Rebagliato, Marisa; Bosch, Susana; Martínez, Encarnación; Bolúmar, Francisco // European Journal of Public Health;Oct2010, Vol. 20 Issue 5, p524 

    Background: Spain has become a principal destination for immigrants and delivery is the major reason for hospitalization in this population. However, research about inequities between native and immigrant women regarding the quality of the care received during pregnancy and delivery is still...

  • Cesarean Section and Operative Vaginal Delivery in Low-Risk Primiparous Women, Western Australia. Read, Anne W.; Prendiville, Walter J.; Dawes, Vivienne P.; Stanley, Fiona J. // American Journal of Public Health;Jan1994, Vol. 84 Issue 1, p37 

    Objectives. A major component of the increasing trend in cesarean sections in Western Australia is the rise in emergency cesarean sections in primiparous women. The aim of this study was to identify independent risk factors (particularly those known early in pregnancy) associated with operative...

  • Prevalence and associated risk factors of retention of urine after caesarean section. Anita Chai; To Wong; Ho-Leung Mak; Cecilia Cheon; Shing-Kai Yip; Assumpta Wong // International Urogynecology Journal;Apr2008, Vol. 19 Issue 4, p537 

    Abstract  Caesarean section poses higher risk of postpartum urinary retention (PUR) than vaginal delivery. The aim of this study was to identify the prevalence and the associated risk factors of PUR after caesarean section. Two hundred seven parturients (mean...

  • Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database. Kozhimannil, Katy B.; Arcaya, Mariana C.; Subramanian, S. V. // PLoS Medicine;Oct2014, Vol. 11 Issue 10, p1 

    Katy Kozhimannil and colleagues use a national database to examine the extent to which variability in cesarean section rates across the US from 2009–2010 was attributable to individual women's clinical diagnoses. Please see later in the article for the Editors' Summary

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics