Differences in nulliparous caesarean section rates across models of care: a decomposition analysis

Brick, Aoife; Layte, Richard; Nolan, Anne; Turner, Michael J.

doi:10.1186/s12913-016-1494-3

BMC Health Services Research

Table 1 Prevalence and Unadjusted Caesarean Section Rates (Elective and Emergency) for Nulliparous Singleton Deliveries by Maternal and Clinical Characteristics, 2009

From: Differences in nulliparous caesarean section rates across models of care: a decomposition analysis

	Prevalence			CS Rate^a
	Prevalence			Elective		Emergency
	Public	Private	p-value	Public	Private	Public	Private
N	22,059	7,811		913	664	4,325	1,890
CS Rate	23.7	32.7		4.1	8.5	19.6	24.2
	%	%		%	%	%	%
Maternal Characteristics
Age (years)
<20	8.9	0.5	0.000***	2.1	0.0	12.0	7.7
20–24	25.0	1.8		2.6	4.4	16.2	15.3
25–29	34.2	17.8		3.8	5.5	18.5	21.6
30–34	22.9	52.5		5.1	7.5	23.5	23.1
35–39	7.9	23.3		7.6	10.9	30.7	28.4
≥40	1.2	4.1		19.6	23.2	31.7	31.0
Social Class
Professional/managerial	21.2	56.5	0.000***	4.2	8.5	21.7	24.1
Clerical	26.0	27.9		4.9	9.0	20.3	25.1
Skilled/semi-skilled	7.3	3.5		4.9	9.9	19.1	22.6
Unskilled	18.2	7.3		4.1	7.9	19.8	24.3
Unemployed	4.6	0.2		3.6	5.9	16.1	23.5
Home duties	15.1	1.9		3.4	6.9	19.0	25.5
Other^b	7.5	2.8		2.5	5.1	14.9	18.9
Marital Status
Married	44.9	83.5	0.000***	4.9	8.8	21.2	24.2
Not married^c	55.1	16.5		3.5	7.2	18.4	24.2
Country of Birth
Ireland	64.2	92.1	0.000***	4.3	8.4	20.7	24.2
UK	2.4	1.6		5.4	14.2	18.5	19.7
EU-15	1.8	2.1		5.7	9.9	19.5	25.3
EU-27^d	20.9	1.2		3.8	6.4	14.9	18.1
Africa	2.4	0.2		3.2	12.5	27.9	31.3
Asia	5.9	1.1		3.2	11.4	21.9	21.6
Other^e	2.4	1.7		4.1	8.5	17.7	31.8
Clinical Characteristics
Obstetric History
Previous miscarriage	13.3	17.9	0.000***	5.8	9.7	23.1	26.8
Gestational Age (weeks)
<33	1.4	1.2	0.460	4.6	3.2	38.5	54.8
33–37	7.8	7.9		5.2	11.4	25.8	27.8
38+	90.8	90.9		4.0	8.3	18.8	23.5
Birthweight (g)
500–2499	5.0	4.1	0.000***	6.4	8.5	35.3	45.1
2500–2999	13.9	11.2		4.5	10.1	17.3	23.7
3000–3499	36.5	34.5		4.6	8.8	15.2	19.6
3500–3999	32.4	35.3		3.2	7.8	18.9	22.4
4000–4499	10.5	12.5		3.1	7.2	29.1	31.4
4500+	1.7	2.4		6.9	13.6	40.8	46.7
Clinical Risk Factors^f
Breech presentation	4.1	4.9	0.005***	66.0	72.6	29.2	25.3
Diabetes mellitus (pre-existing)	0.3	0.2	0.025**	10.7	35.7	50.7	50.0
Gestational diabetes mellitus	1.7	1.0	0.000***	6.8	23.8	33.7	26.3
Eclampsia including pre-eclampsia	3.2	3.5	0.217	5.2	9.3	43.5	52.6
Other malpresentation	0.7	2.0	0.000***	35.4	70.9	43.5	23.4
Placenta praevia or placental abruption	0.6	0.9	0.051*	20.4	47.8	59.2	47.8
Hypertensive disorders	4.7	5.0	0.450	3.3	10.1	31.3	32.6
Poor fetal growth	2.5	2.3	0.353	10.4	15.6	32.0	33.3
Induction of labour	28.9	34.4	0.000***			27.3	32.9
Hospital Characteristics
Academic teaching hospital	47.5	60.9	0.000***	4.0	8.5	18.8	21.6

Percentages columns subject to rounding. Missing values are excluded from the calculation of percentages. ***p < 0.01, **p < 0.05, *p < 0.1
^aCS rates are calculated as a proportion of total deliveries
^bIncludes farmers and farm managers, other agricultural occupations and fisheries workers, and not classifiable
^cIncludes never married, divorced, separated, and widowed
^dAccession States
^eIncludes the Rest of Europe, the Americas, Australia, New Zealand (incl. Oceania), multi-nationality, non-Irish, and no nationality
^fClinical risk factors imply that the relevant diagnosis code(s) appeared as one of the up to 20 diagnosis codes (one principal and up to 19 additional) recorded in HIPE, a woman may have more than one clinical risk factor. The presence of a particular risk factor does not imply that this was the ‘cause’ of the CS
Source: HIPE/NPRS 2009 data

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