Cesarean section rate differences by migration indicators

Gagnon, Anita J.; Hulst, Andraea Van; Merry, Lisa; George, M. Anne; Saucier, Jean‐François; Stanger, Elizabeth; Wahoush, Olive; Stewart, Donna E.

doi:10.1007/s00404-012-2609-7

Cited by 36 publications

(31 citation statements)

References 28 publications

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“…Twenty studies were removed because the comparison group included migrants, and/or the migrant group included native-born, and/or the assembly of the migrant and non-migrant groups were dissimilar. Seventy-six studies met the inclusion criteria and were assigned a quality score (see Table 1 for a complete description of included studies) [15-17,25-103]. Twenty-two studies were scored as good and 54 were scored as fair (see Table 2).…”

Section: Resultsmentioning

confidence: 99%

International migration and caesarean birth: a systematic review and meta-analysis

Merry

Small

Blondel

et al. 2013

BMC Pregnancy Childbirth

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112

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BackgroundPerinatal health disparities including disparities in caesarean births have been observed between migrant and non-migrant women and some literature suggests that non-medical factors may be implicated. A systematic review was conducted to determine if migrants in Western industrialized countries consistently have different rates of caesarean than receiving-country-born women and to identify the reasons that explain these differences.MethodsReports were identified by searching 12 literature databases (from inception to January 2012; no language limits) and the web, by bibliographic citation hand-searches and through key informants. Studies that compared caesarean rates between international migrants and non-migrants living in industrialized countries and that did not have a ‘fatal flaw’ according to the US Preventative Services Task Force criteria were included. Studies were summarized, analyzed descriptively and where possible, meta-analyzed.ResultsSeventy-six studies met inclusion criteria. Caesarean rates between migrants and non-migrants differed in 69% of studies. Meta-analyses revealed consistently higher overall caesarean rates for Sub-Saharan African, Somali and South Asian women; higher emergency rates for North African/West Asian and Latin American women; and lower overall rates for Eastern European and Vietnamese women. Evidence to explain the consistently different rates was limited. Frequently postulated risk factors for caesarean included: language/communication barriers, low SES, poor maternal health, GDM/high BMI, feto-pelvic disproportion, and inadequate prenatal care. Suggested protective factors included: a healthy immigrant effect, preference for a vaginal birth, a healthier lifestyle, younger mothers and the use of fewer interventions during childbirth.ConclusionCertain groups of international migrants consistently have different caesarean rates than receiving-country-born women. There is insufficient evidence to explain the observed differences.

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Section: Resultsmentioning

confidence: 99%

International migration and caesarean birth: a systematic review and meta-analysis

Merry

Small

Blondel

et al. 2013

BMC Pregnancy Childbirth

Self Cite

111

112

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“…Women from HSCs were less likely to have obstetric interventions or obstetric complications. Canadian research has reported higher cesarean delivery rates among primiparous resettled refugees compared with nonrefugee migrants from South‐East and Central Asia, but no difference between refugee and nonrefugee migrants from Africa . Higher cesarean delivery rates have also been reported among multiparous women of refugee background (especially from sub‐Saharan Africa) compared with their general maternity service population .…”

Section: Discussionmentioning

confidence: 99%

Maternal Health and Pregnancy Outcomes Comparing Migrant Women Born in Humanitarian and Nonhumanitarian Source Countries: A Retrospective, Observational Study

Gibson-Helm

Teede

Cheng

et al. 2015

Birth

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“…Both length of time in the receiving country and migration classification have been previously found to be predictors of unplanned cesarean births, but with varying effects based on migrants' region of origin . Migrants with a humanitarian status may be more vulnerable upon arrival and/or transition to poorer health more quickly because of their migration and/or resettlement experiences (i.e., more social exclusion, hardship, and experiences of discrimination) .…”

Section: Discussionmentioning

confidence: 99%

Predictors of Unplanned Cesareans among Low‐Risk Migrant Women from Low‐ and Middle‐Income Countries Living in Montreal, Canada

Merry

Semenic

Gyorkos

et al. 2016

Birth

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Migrant women from sub-Saharan Africa/Caribbean and recently arrived migrant women with a humanitarian classification are at greater risk for unplanned cesareans compared with other low-risk migrant women from LMICs after controlling for medical factors. Strategies to prevent cesareans should consider the circumstances of migrant women that may be contributing to the use of unplanned cesareans in this population.

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Cesarean section rate differences by migration indicators

Abstract: Migration status, source region, and time since migration are informative migration indicators for cesarean section risk.

Cited by 36 publications

References 28 publications

International migration and caesarean birth: a systematic review and meta-analysis

International migration and caesarean birth: a systematic review and meta-analysis

Maternal Health and Pregnancy Outcomes Comparing Migrant Women Born in Humanitarian and Nonhumanitarian Source Countries: A Retrospective, Observational Study

Predictors of Unplanned Cesareans among Low‐Risk Migrant Women from Low‐ and Middle‐Income Countries Living in Montreal, Canada

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