Cesarean section, fetal monitoring and perinatal mortality in California

R.L. Williams and W.E. Hawes

American Journal of Public Health, 1979, vol. 69, issue 9, 864-870

Abstract: The rate of cesarean section in California has been growing at a compound rate of about 10 per cent per annum since 1969, coinciding with the advent of fetal monitoring. It is of interest, therefore, to study the distribution and efficacy of obstetric interventions. Information derived from the 1977 California birth cohort and a survey questionnaire was used to study the factors associated with the rate of cesarean section in 323 hospitals. Significant positive correlations were observed between the cesarean rate (CSR) and hospital factors indicative of a high degree of technology, including the proportion of labors electronically monitored. Significant negative correlations were observed between the CSR and hospital-specific variables suggestive of socioeconomically underprivileged patient populations. Other fators being constant, hospitals characterized by prepayment health care financing also had lower CSRs. A standarridized mortality ratio (SMR) based on 2.3 million births in the 1970-1976 cohorts was used to adjust the 1977 hospital specific perinatal mortality rates for birth weight, gestational age, sex, race, and plurality. The results show that hospitals which intervene technologically in a large proportion of births have lower risk adjusted perinatal mortality rates.

Date: 1979
References: Add references at CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.69.9.864

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.69.9.864_2

DOI: 10.2105/AJPH.69.9.864

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().