title: Perinatal complications and cesarean delivery among foreign-born and Australian-born women in Western Australia, 1998-2006.
abstract: OBJECTIVE
  To determine whether common perinatal complications could explain variation in risk of cesarean among foreign-born and Australian-born women in Western Australia (WA).
  
  
  METHODS
  Complication prevalence was calculated using the linked records of 208 982 confinements to non-indigenous women in WA between 1998 and 2006. Logistic regression was used to estimate differences in risk of elective cesarean and emergency cesarean compared with vaginal delivery for foreign-born women from different regions.
  
  
  RESULTS
  The most common complications in emergency cesareans were failure to progress (36.7%) and fetal distress (35.7%). The most common complications in elective cesareans were previous cesarean (56.2%) and malpresentation (16.3%). Women from Sub-Saharan Africa, Southeast Asia, and Southern and Central Asia had an increased risk of emergency cesarean compared with Australian-born women (P<0.05), whereas women from Oceania, North Africa and the Middle East, and Northeast Asia had a decreased likelihood of elective cesarean compared with Australian-born women (P<0.05).
  
  
  CONCLUSIONS
  Complication prevalence varied by maternal region of birth. However, variation in these complications does not completely explain differences in mode of delivery among foreign-born and Australian-born women in WA. Sociocultural factors must be considered in future research and when establishing culturally appropriate guidelines for obstetric staff dealing with foreign-born women.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia. brilliana.vonkatterfeld@uwa.edu.au
authors.forename: Brilliana
authors.initials: B
authors.lastname: von Katterfeld
authors.forename: Jianghong
authors.initials: J
authors.lastname: Li
authors.forename: Beverley
authors.initials: B
authors.lastname: McNamara
authors.forename: Amanda T
authors.initials: AT
authors.lastname: Langridge
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008498:Medical Record Linkage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult