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Observational Study
. 2020 Jan 4;7(2):627-633.
doi: 10.1002/nop2.433. eCollection 2020 Mar.

Geospatial variation in caesarean delivery

Jennifer Vanderlaan  1 , Johnathan A Edwards  2 , Anne Dunlop  3
Affiliations
Observational Study

Geospatial variation in caesarean delivery

Jennifer Vanderlaan et al. Nurs Open. .

Abstract

Aim: The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters.

Design: This was a retrospective, observational study.

Methods: Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's t test and chi-squared test.

Results: Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; p < .001). Counties in high-rate clusters had significantly lower access to midwives, more deliveries paid by Medicaid, higher proportion of births for women belonging to racial/ethnic minority groups and were more likely to be rural.

Keywords: caesarean section; maternal health services; nurses; nursing; spatial analysis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

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References

    1. ACOG Committee Opinion No (2014). 586: Health disparities in rural women. Obstetrics & Gynecology, 123(2 Pt 1), 384–388. - PubMed
    1. ACOG Practice Bulletin No (2019). 205: Vaginal Birth After Cesarean Delivery. Obstetrics & Gynecology, 133(2), e110–e127. - PubMed
    1. Agency for Healthcare Research and Quality . Inpatient Quality Indicators Technical Specifications ‐ Version 4.5, May 2013. 2013; http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSpec.aspx. Accessed March 31, 2014.
    1. American College of Obstetricians and Gynecologists (College) ; Society for Maternal‐Fetal Medicine , Caughey, A. B. , Cahill, A. G. , Guise, J. M. , & Rouse, D. J. Safe prevention of the primary cesarean delivery. American Journal of Obstetrics and Gynecology. 2014;210(3):179–193. 10.1016/j.ajog.2014.01.026 - DOI - PubMed
    1. Attanasio, L. B. , & Paterno, M. T. (2019). Correlates of Trial of Labor and Vaginal Birth After Cesarean in the United States. Journal of Women's Health 28(9), 1302–1312. 10.1089/jwh.2018.7270 - DOI - PubMed

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