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

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Liu, M, Xue, M, Yang, Q, Du, W ORCID: https://orcid.org/0000-0002-5115-7214, Yan, X, Tan, J, Duan, T and Hua, J, 2021. Association between migration status and caesarean section delivery based on a modified Robson classification in China. BMC Pregnancy and Childbirth, 21: 215. ISSN 1471-2393

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Official URL: https://doi.org/10.1186/s12884-021-03708-6

Abstract

Background: China has one of the highest caesarean section (C-Section) rates in the world. In recent years, China has been experiencing a massive flow of migration due to rapid urbanization. In this study, we aimed to differentiate the rates of C-Section between migrants and residents, and explore any possible factors which may moderate the association between migrant status and C-Section rates.

Methods: We conducted a retrospective cohort study in Shanghai, China. All deliveries were classified using the modified Robson Classification. The association between women’s migrant status and C-Section rates was assessed using the Poisson regression of sandwich estimation, after adjusting for possible factors.

Results: Of the 40621 women included in the study, 66.9% were residents and 33.1% were internal migrants. The rate of C-Section in migrants was lower than that of residents in all subjects (39.9% and 47.7%) and in group 1 subjects (based on the Robson Classification) using a modified Robson Classification. There was an association between migrant status and caesarean delivery on maternal request that was statistically significant (RR=0.664, p is less than 0.001), but the association was weakened after adjusting for such factors as maternal age at delivery (aRR=0.774, p=0.02), ethnicity (aRR=0.753, p is less than 0.001), health insurance (aRR=0.755, p is less than 0.001), and occupation (aRR=0.747, p=0.004), but had no significant changes when adjusting for health conditions (aRR=0.668, p=0.001) and all considering variables (aRR=0.697, p=0.002). In group 1 subjects, the effect of migrant status on maternal requested intrapartum C-Section was also statistically significant (RR=0.742, p=0.004).

Conclusion: C-Section rates are lower among migrant women than residents, especially on maternal request. The medical practitioners should further reinforce the management of elective C-Section in resident women.

Item Type:	Journal article
Publication Title:	BMC Pregnancy and Childbirth
Creators:	Liu, M., Xue, M., Yang, Q., Du, W., Yan, X., Tan, J., Duan, T. and Hua, J.
Publisher:	BioMed Central Ltd.
Date:	17 March 2021
Volume:	21
ISSN:	1471-2393
Identifiers:	Number Type 10.1186/s12884-021-03708-6 DOI 1424759 Other
Rights:	© the author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Divisions:	Schools > School of Social Sciences
Record created by:	Jill Tomkinson
Date Added:	16 Mar 2021 15:38
Last Modified:	31 May 2021 15:04
URI:	https://irep.ntu.ac.uk/id/eprint/42519