title: Cesarean section delivery among primiparous women in rural China: an emerging epidemic.
abstract: OBJECTIVE
  The purpose of this study was to describe the trends and determinants of cesarean section (CS) delivery rates in rural China.
  
  
  METHODS
  Data on rural primiparous women aged 15-49 years (n = 10,754) were obtained from 3 nationwide representative surveys in 1993, 1998, and 2003. The CS rate per 100 births and odds ratios by women's background characteristics were calculated with the use of logistic regression.
  
  
  RESULTS
  The CS rate increased from 1% in 1991 to 17% in 2002. After age adjustment, CS was most common among more educated women, who lived in Eastern China, who had high household income and health insurance, who used antenatal care, and who gave birth at a high-level hospital.
  
  
  CONCLUSIONS
  This development over the 10-year period may indicate very high CS rates in the near future; the epidemic of the use of CS that has been observed in urban China is likely to occur also in rural China. Further studies on the reasons and consequences of such excessive use of operative delivery are needed.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Reija
authors.initials: R
authors.lastname: Klemetti
authors.forename: Xuan
authors.initials: X
authors.lastname: Che
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.forename: Joanna
authors.initials: J
authors.lastname: Raven
authors.forename: Zhuochun
authors.initials: Z
authors.lastname: Wu
authors.forename: Shenglan
authors.initials: S
authors.lastname: Tang
authors.forename: Elina
authors.initials: E
authors.lastname: Hemminki
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D002681:China; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D010298:Parity; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data* / Q000639:trends; D012959:Socioeconomic Factors; D055815:Young Adult