Related Experiment Video
Updated: Jul 4, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Nulliparous term singleton vertex cesarean delivery rates: institutional and individual level predictors
Dean V Coonrod1, David Drachman, Paula Hobson
1Department of Obstetrics, Maricopa Integrated Health System/MedPro, Phoenix, AZ, USA.
American Journal of Obstetrics and Gynecology
|June 10, 2008
Summary
Cesarean delivery rates for first-time mothers giving birth to a single baby at term vary significantly between hospitals. Factors like maternal age, race, birthweight, and hospital type influence these cesarean delivery rates.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Health Services Research
Background:
- Cesarean delivery is a major surgical procedure with associated risks.
- Nulliparous term singleton vertex (NTSV) cesarean delivery rates vary widely across institutions.
- Understanding predictors of NTSV cesarean delivery is crucial for improving maternal care.
Purpose of the Study:
- To identify individual and institutional factors associated with variations in NTSV cesarean delivery rates.
- To analyze data from a large cohort of births across multiple hospitals.
Main Methods:
- Retrospective cohort study.
- Involved 28,863 NTSV births across 40 Arizona hospitals.
- Multivariable modeling was used to assess predictive variables.
Main Results:
- Average NTSV cesarean delivery rate was 22.0%, with rates ranging from 10.3% to 34.2%.
- Individual factors increasing risk included advanced maternal age, African American race, higher birthweight, labor induction, diabetes, and hypertension.
- Institutional factors associated with lower risk included higher nursery level and more government-paid births. Hospitals with the lowest care level or OB/GYN residency programs showed increased risk.
Conclusions:
- Significant variations in NTSV cesarean delivery rates exist among hospitals.
- Both individual patient characteristics and hospital-level factors contribute to these disparities.
- Further research and targeted interventions are needed to reduce unnecessary cesarean deliveries.
