262540 Regional variation in cesarean section

Sunday, October 28, 2012

Kathryn Russell , Department of Health Systems Management, Rush University, Chicago, IL
Briana Jegier, PhD, CLC , College of Nursing, Women's and Children's Health Nursing, Rush University, Chicago, IL
Samuel Hohmann, PhD, MS , Comparative Data & Informatics Research, UHC, Chicago, IL
Melinda Noonan, DNP, RN, NEA-BC , Nursing Operations, Rush University, Chicago, IL
Background and Objective: Cesarean section (CS) rates have risen in the United States (US). This study examined regional differences in maternal and infant characteristics for women who had a primary CS in the US.

Study Design/ Population Studied: This retrospective cross sectional study examined all singleton deliveries among women (n=299,316) who had not previously had CS and who delivered at UHC member hospitals in the US between July 1, 2010 and June 30, 2011. Data were extracted from UHC's Clinical Data Mart, an administrative claims data repository. Maternal, infant, and clinical characteristics were identified using the principal and secondary ICD9-CM diagnosis codes and socio-demographic variables listed in the administrative claims data. The Nine US regions were defined using the US census definitions.

Results/Principal Findings: There were 62,068 primary cesarean sections (21.7%) during the study period. Primary CS births were lowest in the Mountain Region (14.4% of births) and highest in Middle Atlantic Region (23.0% of births). CS by region also varied by maternal characteristics, particularly obesity. 18.4% of CS in the East South Central region were for obese women while only 6.3% of CS in the Pacific region were for obese women. Obesity was a predictor of CS (p<.001) even after adjusting for regional variation in CS.

Conclusions and Implications: There is regional variations in CS in the US. There is also regional variations in CS in the US by maternal characteristics, particularly obesity. This suggests that interventions to reduce CS rates need to consider both regional and maternal characteristics.

Learning Areas:
Public health or related research

Learning Objectives:
Discuss regional variation in cesarean section in the United States

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the M.S. student responsible for the project outlined in the submitted abstract. Among my research interests has been the development of my Master's Project in which I am the co-principal examining regional variation in cesarean section.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.