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Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland

BACKGROUND: Caesarean section (CS) rates especially without medical indication are rising worldwide. Most of indications for CS are relative and CS rates for various indications vary widely. There is an increasing tendency to perform CSs without medical indication on maternal request. Women with hig...

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Autores principales: Räisänen, Sari, Gissler, Mika, Kramer, Michael R, Heinonen, Seppo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999387/
https://www.ncbi.nlm.nih.gov/pubmed/24678806
http://dx.doi.org/10.1186/1471-2393-14-120
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author Räisänen, Sari
Gissler, Mika
Kramer, Michael R
Heinonen, Seppo
author_facet Räisänen, Sari
Gissler, Mika
Kramer, Michael R
Heinonen, Seppo
author_sort Räisänen, Sari
collection PubMed
description BACKGROUND: Caesarean section (CS) rates especially without medical indication are rising worldwide. Most of indications for CS are relative and CS rates for various indications vary widely. There is an increasing tendency to perform CSs without medical indication on maternal request. Women with higher socioeconomic status (SES) are more likely to give birth by CS. We aimed to study whether giving birth by CS was associated with SES and other characteristics among singleton births during 2000–2010 in Finland with publicly funded health care. METHODS: Data were gathered from the Finnish Medical Birth Register. The likelihood of giving birth by CS according to CS type (planned and non-planned), parity (nulliparous vs. multiparous), socio-demographic factors, delivery characteristics and time periods (2000–2003, 2004–2007 and 2008–2010) was determined by using logistic regression analysis. SES was classified as upper white collar workers (highest SES), lower white collar workers, blue collar workers (lowest SES), others (all unclassifiable cases) and cases with missing information. RESULTS: In total, 19.8% (51,511 of 259,736) of the nulliparous women and 13.1% (47,271 of 360,727) of the multiparous women gave birth by CS. CS was associated with several delivery characteristics, such as placental abruption, placenta previa, birth weight and fear of childbirth, among both parity groups. After adjustment, the likelihood of giving birth by planned CS was reduced by 40% in nulliparous and 55% in multiparous women from 2000–2003 to 2008–2010, whereas the likelihood of non-planned CSs did not change. Giving birth by planned and non-planned CS was up to 9% higher in nulliparous women and up to 17% higher in multiparous women in the lowest SES groups compared to the highest SES group. CONCLUSIONS: Giving birth by CS varied by clinical indications. Women with the lowest SES were more likely to give birth by CS, indicating that the known social disparity in pregnancy complications increases the need for operative deliveries in these women. Overall, the CS policy in Finland shows favoring a trial of labor over planned CS and reflects no inequity in healthcare services.
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spelling pubmed-39993872014-04-26 Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland Räisänen, Sari Gissler, Mika Kramer, Michael R Heinonen, Seppo BMC Pregnancy Childbirth Research Article BACKGROUND: Caesarean section (CS) rates especially without medical indication are rising worldwide. Most of indications for CS are relative and CS rates for various indications vary widely. There is an increasing tendency to perform CSs without medical indication on maternal request. Women with higher socioeconomic status (SES) are more likely to give birth by CS. We aimed to study whether giving birth by CS was associated with SES and other characteristics among singleton births during 2000–2010 in Finland with publicly funded health care. METHODS: Data were gathered from the Finnish Medical Birth Register. The likelihood of giving birth by CS according to CS type (planned and non-planned), parity (nulliparous vs. multiparous), socio-demographic factors, delivery characteristics and time periods (2000–2003, 2004–2007 and 2008–2010) was determined by using logistic regression analysis. SES was classified as upper white collar workers (highest SES), lower white collar workers, blue collar workers (lowest SES), others (all unclassifiable cases) and cases with missing information. RESULTS: In total, 19.8% (51,511 of 259,736) of the nulliparous women and 13.1% (47,271 of 360,727) of the multiparous women gave birth by CS. CS was associated with several delivery characteristics, such as placental abruption, placenta previa, birth weight and fear of childbirth, among both parity groups. After adjustment, the likelihood of giving birth by planned CS was reduced by 40% in nulliparous and 55% in multiparous women from 2000–2003 to 2008–2010, whereas the likelihood of non-planned CSs did not change. Giving birth by planned and non-planned CS was up to 9% higher in nulliparous women and up to 17% higher in multiparous women in the lowest SES groups compared to the highest SES group. CONCLUSIONS: Giving birth by CS varied by clinical indications. Women with the lowest SES were more likely to give birth by CS, indicating that the known social disparity in pregnancy complications increases the need for operative deliveries in these women. Overall, the CS policy in Finland shows favoring a trial of labor over planned CS and reflects no inequity in healthcare services. BioMed Central 2014-03-31 /pmc/articles/PMC3999387/ /pubmed/24678806 http://dx.doi.org/10.1186/1471-2393-14-120 Text en Copyright © 2014 Räisänen et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Räisänen, Sari
Gissler, Mika
Kramer, Michael R
Heinonen, Seppo
Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title_full Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title_fullStr Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title_full_unstemmed Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title_short Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in Finland
title_sort influence of delivery characteristics and socioeconomic status on giving birth by caesarean section – a cross sectional study during 2000–2010 in finland
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999387/
https://www.ncbi.nlm.nih.gov/pubmed/24678806
http://dx.doi.org/10.1186/1471-2393-14-120
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