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Cesarean sections in upstate New York, 1968-1978

M S Zdeb, G D Therriault, V M Logrillo

    American Journal of Epidemiology
    |September 1, 1980
    PubMed
    Summary
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    Birth (Berkeley, Calif.)·1989

    Cesarean section rates significantly increased from 1968 to 1978 in upstate New York. Wide hospital variations in primary cesarean sections emerged, with changing associations to neonatal mortality and breech deliveries.

    Area of Science:

    • Obstetrics and Gynecology
    • Public Health
    • Epidemiology

    Background:

    • Cesarean section (C-section) use has seen significant shifts over time.
    • Understanding trends in C-section rates is crucial for maternal and infant health outcomes.

    Purpose of the Study:

    • To analyze the changing trends in cesarean section rates between 1968 and 1978 in upstate New York.
    • To investigate variations in primary cesarean section use among population subgroups and hospitals.
    • To examine the relationship between cesarean section rates, hospital characteristics, and perinatal outcomes.

    Main Methods:

    • Utilized birth certificate data from upstate New York for the years 1968-1978.
    • Analyzed cesarean section percentages across different population subgroups.

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  • Compared hospital-to-hospital variations in primary cesarean section rates.
  • Assessed correlations between cesarean section rates, hospital size, neonatal mortality, and breech delivery percentages.

    • Main Results:

    • The overall percentage of births via cesarean section quadrupled from 1968 to 1978.
    • Increases in cesarean section rates varied from 1.5 to 5 times the 1968 levels across population subgroups.
    • Hospital variation in primary cesarean section rates increased dramatically from 1968-1969 to 1977-1978.
    • Neonatal mortality was linked to cesarean section rates in 1968-1969 but not in 1977-1978.
    • An inverse relationship emerged between breech delivery rates and cesarean section rates in 1977-1978.

    Conclusions:

    • Cesarean section utilization experienced a substantial rise in upstate New York during the study period.
    • Significant disparities in cesarean section practices emerged among hospitals.
    • The relationship between cesarean section rates and neonatal outcomes evolved over the decade, with breech presentation becoming a key factor.