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Race/ethnic differentials in heavy weight and cesarean births

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Abstract

Objectives: The general objectives of this research are tofurther our understanding of the distribution and incidence of heavy weight births and to examine differentials in the use of cesarean section as a response to macrosomia in models that are more broadly comparative by race/ethnicity than any that have heretofore been estimated. Methods: The data are drawn from the combined 1989–1991 NCHS Linked Birth/Infant Death Cohort Files,a data set of over 12 million live births and over 100,000 infant deaths that allows for highly reliable estimations for relatively small race/ethnic sub populations. Results: The results confirm that previously identified determinants of macrosomia such as maternal diabetes,maternal weight gain, parity and a previous heavy weight infant are highly predictive of a macrosomic birth, independent of race/ethnic effects. With respect to the management of heavy weight births, race/ethnic differentials exist in the odds of a cesarean delivery, theprocedure most often used to limit the risks of a macrosomic delivery.

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References

  • Alexander, G.R., Tomkins, M.E., Allen, M.C. & Hulsey, T.C.(1999).Trends and racial differences in birth weight and related survival, Maternal and Child Health Journal 3(1): 71–79.

    Google Scholar 

  • Brunskill, A.J., Rossing, M.A., Connell, F.A. & Daling, J.(1991).Antecedents of macrosomia, Paediatric and Perinatal Epidemiology 5: 392–401.

    Google Scholar 

  • Buehler, J.W., Strauss, L.T., Hogue, C.J.R. & Smith, J.C.(1987).Birth weight specific causes of infant mortality, United States, 1980, Public Health Report 102(2): 162–170.

    Google Scholar 

  • Casey, B.M., Lucas, M.J., McIntire, D.D. & Leveno, K.J.(1997).Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population, Obstetrics and Gynecology 90(6): 869–873.

    Google Scholar 

  • Chomitz, V.R., Cheung, L.W.Y. & Lieberman, E.(1995).The role of lifestyle in preventing low birth weight, The Future of Children 5: 121–138.

    Google Scholar 

  • Cramer, J.C.(1987).Social factors and infant mortality: Identifying high-risk groups and proximate causes, Demography 24: 299–322.

    Google Scholar 

  • David, R.(1990).Race, birth weight and mortality rates, Journal of Pediatrics 116: 101–102.

    Google Scholar 

  • Essel, J.K. & Opei-Tetteh, E.T.(1995).Macrosomia-maternal and fetal risk factors, South African Medical Journal 85(1): 43–46.

    Google Scholar 

  • Frisbie, P.W., Biegler, M., de Turk, P., Forbes, D. & Pullum, S.G.(1997).Racial and ethnic differences in determinants of intrauterine growth retardation and other compromised birth outcomes, American Journal of Public Health 87(12): 1977–1983.

    Google Scholar 

  • Frisbie, P.W., Forbes, D. & Hummer, R.A.(1998).Hispanic pregnancy outcomes: Additional evidence, Social Science Quarterly 79(1): 149–169.

    Google Scholar 

  • Gortmaker S.L. & Wise, P.H.(1997).The first injustice: Socioeconomic disparities, health service technology and infant mortality, Annual Review of Sociology 23: 147–171.

    Google Scholar 

  • Gross, T.L., Sokol, R.J., Williams, T. & Thompson, K.(1987).Shoulder dystocia: A fetalphysician risk, American Journal of Obstetrics and Gynecology 156(6): 1408–1418.

    Google Scholar 

  • Hogue, C.J.R., Buehler, J.W., Strauss, L.T., et al.(1987).Overview of the National Infant Mortality Surveillance (NIMS) project-design, methods, results, Public Health Report 1987: 126–138.

  • Homko, C.J., Sivan, E., Nyirjesy, P. & Reece, E.A.(1995).The interrelationship between ethnicity and gestational diabetes in fetal macrosomia, Diabetes Care 18(11): 1442–1445.

    Google Scholar 

  • Hopkins, K.(2000).Are Brazilian women really choosing to deliver by cesarean?, Social Science and Medicine 51: 725–740.

    Google Scholar 

  • Hueston, W.J. & McClaflin, R.R.(1996).Variations in cesarean delivery for fetal distress, The Journal of Family Practice 43(5): 461–467.

    Google Scholar 

  • Hummer, R.A., Eberstein, I.W. & Nam, C.B.(1992).Infant mortality differentials among Hispanic groups in Florida, Social Forces 10: 1055–1075.

    Google Scholar 

  • Kieffer, E.C., Alexander, G.R. & Mor, J.M.(1995).Pregnancy outcomes of Pacific islanders in Hawaii, American Journal of Epidemiology 141(7): 674–679.

    Google Scholar 

  • Kieffer, E.C., Alexander, G.R., Kogan, M.D.et al.(1998).Influence of diabetes during pregnancy on gestational age-specific newborn weight among US black and US white infants, American Journal of Epidemiology 147(11): 1053–1061.

    Google Scholar 

  • Kleinman, J. & Kessel, S.S.(1987).Racial differences in low birth weight: Trends and risk factors, New England Journal of Medicine 317: 749–753.

    Google Scholar 

  • Kotelchuck, M.(1994).The adequacy of prenatal care utilization index: Its US distribution and association with low birthweight,American Journal of Public Health 84(9): 1486–1488.

    Google Scholar 

  • Langer, O., Berkus, M.D., Huff, R.W. & Samueloff, A.(1991).Shoulder dystocia: Should the fetus weighing ≥4000 g be delivered by cesarean section?, American Journal of Obstetrics and Gynecology 165(4): 831–837.

    Google Scholar 

  • McKenzie, L. & Stephenson, P.A.(1993).Variation in cesarean section rates among hospitals in Washington State, American Journal of Public Health 83(8): 1109–1112.

    Google Scholar 

  • Mimouni, F., Miodovnik, M., Rosenn, B., Khoury, J. & Siddiqi, T.A.(1992).Birth trauma in insulin-dependent diabetic pregnancies,American Journal of Perinatology 9(3): 205–208.

    Google Scholar 

  • Minkoff, H.L. & Schwarz, R.H.(1980).The rising cesarean section rate: Can it safely be reversed?, Obstetrics and Gynecology 56: 135–143.

    Google Scholar 

  • Rogers, R.G.(1989).Ethnic differences in infant mortality: Fact or artifact?, Social Science Quarterly 70(3): 642–649.

    Google Scholar 

  • Sacks, D.A.(1993).Fetal macrosomia and gestational diabetes: What's the problem?, Obstetrics and Gynecology 81(5): 775–781.

    Google Scholar 

  • Singh, G.K. & Yu, S.M.(1994).Birthweight differentials among Asian Americans, American Journal of Public Health 84(9): 1444–1449.

    Google Scholar 

  • Singh, G.K. & Yu, S.M.(1996).Adverse pregnancy outcomes: Difference between US-and foreign-born women in major US racial and ethnic groups, American Journal of Public Health 86: 837–843.

    Google Scholar 

  • Sokol, R.J., Rosen, M.G., Bottoms, S.F. & Chik, L.(1982).Risks preceding increased primary cesarean birth rates, Obstetrics and Gynecology 59(3): 340–346.

    Google Scholar 

  • Stevenson, D.K., Cohen, R.S. & Kerner, J.A.(1982).Macrosomia: Causes and consequences, The Journal of Pediatrics 100(4): 515–520.

    Google Scholar 

  • Thomson, M.(1990).Heavy birthweight in Native Indians of British Columbia, Canadian Journal of Public Health 81: 443–446.

    Google Scholar 

  • US Department of Health and Human Services (1980).The International Classification of Diseases, 9th rev., Volume 1, Washington, DC: US Government Printing Office.

    Google Scholar 

  • US Department of Health and Human Services (1995).Linked Birth/Infant Death Data Set: 1991 Cohort, Public Use File Documentation, Hyattsville: National Center for Health Statistics.

    Google Scholar 

  • Wilcox, A.J. & Russel, I.T.(1983).Birthweight and perinatal mortality, II: On weight-specific mortality, International Journal of Epidemiology 12: 319–325.

    Google Scholar 

  • Williams, D.R.(1997).Race and health: Basic questions, emerging directions, Annals of Epidemiology 7: 322–333.

    Article  Google Scholar 

  • Wise, P.H.(1993).Confronting racial disparities in infant mortality: Reconciling science and politics, American Journal of Preventative Medicine 9(suppl): 7–16.

    Google Scholar 

  • Woolbright, L.A.(1996).Why is the cesarean delivery rate so high in Alabama? An examination of risk factors, 1991–1993, Birth 21(1): 20–25.

    Google Scholar 

Download references

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Frank, R., Frisbie, W.P. & Pullum, S.G. Race/ethnic differentials in heavy weight and cesarean births. Population Research and Policy Review 19, 459–475 (2000). https://doi.org/10.1023/A:1010656522963

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