Delivery mode by race for breech presentation in the US.
OBJECTIVE
To determine if there are differential cesarean delivery rates by race and other socio-demographic factors for women with breech infants.


METHODS
We calculated cesarean delivery rates for 186 727 White, African American, Hispanic and Asian women delivering breech singletons with gestational age 26 to 41 weeks born in 1999 and 2000 using data from the National Center for Health Statistics. Multivariable logistic regression was used to determine differences in mode of delivery by race, adjusting for socio-demographic and medical factors.


RESULTS
Cesarean rates for breech were >80% in most gestational age groups. In 14 of 18 groups, Whites had higher cesarean delivery rates than African Americans. However, this finding did not persist after risk adjustment. Hispanics were more likely to deliver by cesarean delivery than African Americans and Whites.


CONCLUSIONS
Breech singleton infants are predominantly born by cesarean delivery. Although African-American women with breech presentation have lower cesarean delivery rates than Whites, this difference is not present after adjusting for socio-demographic and medical factors. Hispanics were more likely to be delivered by cesarean delivery and this difference was amplified after risk adjustment. Asians had slightly lower cesarean rates after risk adjustment, but this varied widely according to Asian subgroup.
Lee
H C
HC
Department of Pediatrics, Stanford University, Stanford, CA 94304, USA. hclee@stanford.edu
El-Sayed
Y Y
YY
Gould
J B
JB
D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D001946:Breech Presentation / Q000208:ethnology*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D014481:United States / Q000453:epidemiology