Ethnic disparity in the success of vaginal birth after cesarean delivery

J Matern Fetal Neonatal Med. 2006 Aug;19(8):483-7. doi: 10.1080/14767050600847809.

Abstract

Objective: To estimate whether maternal race/ethnicity is independently associated with successful vaginal birth after cesarean delivery (VBAC).

Study design: A retrospective cohort study from January 1, 1997 to July 30, 2002 of women with singleton pregnancies and a previous cesarean delivery. The odds ratio (OR) for successful VBAC as a function of ethnicity was corrected for age >35 years, parity, weight gain, diabetes mellitus, hospital site, prenatal care provider, gestational age, induction, labor augmentation, epidural analgesia, and birth weight >4000 g.

Results: Among 54 146 births, 8030 (14.8%) occurred in women with previous cesarean deliveries. The trials of labor rates were similar among Caucasian (46.6%), Hispanic (45.4%), and African American (46.0%) women. However, there was a significant difference among ethnic groups for VBAC success rates (79.3% vs. 79.3% vs. 70.0%, respectively). When compared to Caucasian women, the adjusted OR for VBAC success was 0.37 (95% confidence interval (CI) 0.27-0.50) for African American women and 0.63 (95% CI 0.51-0.79) for Hispanic women.

Conclusion: African American and Hispanic women are significantly less likely than Caucasian women to achieve successful VBAC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans*
  • Birth Weight
  • Cesarean Section, Repeat / statistics & numerical data
  • Cohort Studies
  • Confidence Intervals
  • European Continental Ancestry Group*
  • Female
  • Hispanic Americans*
  • Humans
  • Logistic Models
  • Odds Ratio
  • Pregnancy
  • Pregnancy Outcome / ethnology
  • Retrospective Studies
  • Risk Factors
  • Trial of Labor
  • Uterine Rupture / ethnology
  • Uterine Rupture / etiology
  • Vaginal Birth after Cesarean* / adverse effects