Risk Factors for Primary Cesarean Delivery in Low‐Risk Women Across the United States Census Regions
Jessica Guerrette, Joanne Chopak‐Foss, Logan CowanABSTRACT
Objective
To examine differences in low‐risk cesarean delivery rates based on socioeconomic factors and whether selected socioeconomic factors increased the odds of cesarean delivery among women within the United States and among U.S. census regions.
Methods
Data from CDC Wonder were used to identify all singleton live births in the cephalic presentation with gestation between 39 and 41 weeks resulting from primipara women with no prenatal risk factors from 2016 to 2022. Odd ratios and 95% confidence intervals were calculated to assess the association between race/ethnicity, insurance status, and dwelling with cesarean delivery odds.
Results
Out of 4,484,225 deliveries, 21.3% had a cesarean. African American/Black women had 1.54 (95% CI: 1.51, 1.57) times the odds of having a cesarean compared to non‐Hispanic white women. Women covered by Medicaid had 1.01 (95% CI: 1.00, 1.05) times the odds of having a cesarean compared to those with private insurance. Women residing in urban areas had 1.03 (1.01, 1.05) times the odds of those residing in rural areas.
Discussion
A national estimate of low‐risk cesarean deliveries using the SFMF definition and further restrictions reported a rate of 23.9% from 2016 to 2022. African American/Black women had higher odds of cesarean delivery on a national and regional level in the U.S.