title: Predictors of emergency cesarean delivery among international migrant women in Canada.
abstract: OBJECTIVE
  To determine the predictors of emergency cesarean delivery among international migrant women.
  
  
  METHODS
  Between February 2006 and May 2009, 1025 postpartum migrant women were recruited from 12 hospitals in Toronto, Montreal, and Vancouver. Logistic regression was used to model migration, social, health service, and biomedical factors predictive of emergency cesarean.
  
  
  RESULTS
  Overall, 14% percent of participants underwent emergency cesarean. The greatest risk was for women having their first delivery (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.1-11.3); newborns weighing 4000g or more (OR, 3.5; 95% CI, 1.9-6.5); no health insurance (OR, 2.8; 95% CI, 1.2-6.4); delivery on a Friday (OR, 2.2; 95% CI, 1.2-3.9); incomes of less than 30 000 Canadian dollars (OR, 1.9; 1.2-3.0); and induced labor (OR, 1.8; 95% CI, 1.1-3.0). Compared with immigrants, asylum seekers (OR, 0.3; 95% CI, 0.2-0.6) and refugees (OR, 0.5; 95% CI, 0.2-1.0) were protected against emergency cesarean.
  
  
  CONCLUSIONS
  Indicators specific to, or more common among, migrants were informative in assessing the likelihood of emergency cesarean. The risk associated with being uninsured, day of delivery, income, and immigration class suggests the importance of considering non-biomedical factors in reducing the need for emergency cesarean among migrants.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal, Canada. anita.gagnon@mcgill.ca
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Gagnon
authors.forename: Lisa
authors.initials: L
authors.lastname: Merry
authors.forename: Kristen
authors.initials: K
authors.lastname: Haase
mesh_terms: D001724:Birth Weight; D001955:British Columbia; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004630:Emergencies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007182:Income; D007231:Infant, Newborn; D016015:Logistic Models; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D009864:Ontario; D011247:Pregnancy; D011792:Quebec; D012036:Refugees / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors