Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts.
Am J Perinatol. 2019 Mar;36(4):335-340. doi: 10.1055/s-0038-1672170. Epub 2018 Oct 3.
Asian-Indian women are a growing population in the United States, but little data exist about their risk of cesarean delivery (CD). We characterize the odds of CD among Asian-Indian women and determine whether neonatal birth weight modifies this relationship.
This is a retrospective cohort study using an administrative perinatal database from California. We identified 1,029,940 nulliparous women with live, singleton, nonanomalous deliveries between 37 and 42 completed weeks of gestation. We performed multivariable logistic regression analyses to determine if Asian-Indian women were more likely to deliver by CD, compared with white non-Hispanic women, adjusting for sociodemographic and clinical variables. We explored if birth weight was an effect modifier, testing the interaction term's significance using Wald's test, and performed multivariable logistic regressions stratified by birth weight category.
Asian-Indian women comprised 2.0% of the cohort. Compared with white non-Hispanic women, Asian-Indian women had an adjusted odds of 1.41 (95% confidence interval: 1.36-1.46) for CD. However, we noted effect modification of birth weight on the odds of CD by race/ethnicity ( < 0.001). Among all birth weight categories exceeding 3,000 g, Asian-Indian women had higher odds of CD than white non-Hispanic women.
Asian-Indian women are at greater risk of CD than white non-Hispanic women when birthweight exceeds 3,000 g.
亚裔印度女性是美国不断增长的人口群体，但有关她们剖宫产（CD）风险的数据很少。我们描述了亚裔印度女性发生 CD 的几率，并确定新生儿出生体重是否改变了这种关系。
这是一项使用加利福尼亚州围产期行政数据库的回顾性队列研究。我们确定了 1,029,940 名 37 至 42 孕周足月、单胎、无异常分娩的初产妇。我们进行了多变量逻辑回归分析，以确定与白人非西班牙裔女性相比，亚裔印度女性是否更有可能通过 CD 分娩，调整了社会人口统计学和临床变量。我们探讨了出生体重是否为效应修饰剂，使用 Wald 检验检验交互项的显著性，并根据出生体重类别进行多变量逻辑回归分层。
亚裔印度女性占队列的 2.0%。与白人非西班牙裔女性相比，亚裔印度女性 CD 的调整比值比为 1.41（95%置信区间：1.36-1.46）。然而，我们注意到出生体重对种族/民族的 CD 几率存在效应修饰（ < 0.001）。在所有超过 3,000 g 的出生体重类别中，亚裔印度女性 CD 的几率均高于白人非西班牙裔女性。
当出生体重超过 3,000 g 时，亚裔印度女性发生 CD 的风险高于白人非西班牙裔女性。
