Association between migration status and caesarean section delivery based on a modified Robson classification in...

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Sociomedical Sciences

Background:

• China faces high rates of caesarean section (C-Section).
• Rapid urbanization in China drives significant internal migration.
• Understanding C-Section disparities between migrants and residents is crucial.

Purpose of the Study:

• To compare C-Section rates between migrant and resident women in Shanghai.
• To identify factors influencing the association between migrant status and C-Section rates.

Main Methods:

• A retrospective cohort study was conducted in Shanghai, China.
• Deliveries were classified using the modified Robson Classification.
• Poisson regression with sandwich estimation analyzed the association between migrant status and C-Section rates, adjusting for covariates.

Main Results:

• The study included 40,621 women (33.1% migrants).
• Migrant women had lower C-Section rates than residents (39.9% vs. 47.7%).
• Migrant status was significantly associated with lower rates of C-Section on maternal request, even after adjusting for age, ethnicity, insurance, and occupation.

Conclusions:

• C-Section rates are demonstrably lower in migrant women compared to residents, especially for maternal requests.
• Healthcare providers should focus on managing elective C-Sections in resident women to address disparities.