Socioeconomic differences in rates of cesarean section

Article Abstract:

Increasing rates of cesarean section (child delivery through a surgical incision in the abdomen and uterus of the mother) have focused attention on variations in the use of this procedure that seem to be independent of purely medical reasons. (The cesarean sections discussed here are those not performed as an emergency measure interrupting normal delivery). The relationship between cesarean section rates and socioeconomic status was investigated in 250,000 sigleton (not twins, etc.) infants born to black, non- Hispanic white, Asian-American, and Mexican-American residents of Los Angeles county. Using birth certificate data for 1982 and 1983 a significant relationship, independent of maternal age, maternal history of producing viable children, or birth weight was found between cesarean section rates and socioeconomic status. Women who lived in areas with median family incomes over $30,000 had a cesarean section rate of 23 percent. Women living in areas with median family incomes under $11,000, on the other hand, had only 13 percent of their births via cesarean sections. For women between the ages of 18 and 34, reported complications of pregnancy or childbirth occurred in 11 percent of the lowest-income women, compared with 17 percent of the highest-income group. This difference accounted for 42 percent of the difference in cesarean section rates between them. When complications occurred, 65 percent of the lowest-income women and 80 percent of the highest-income women had cesarean sections. When there were no complications, the lowest-income women had cesarean sections 6.5 percent of the time and the highest-income women had them 10.5 percent of the time; this accounted for 41 percent of the difference in their cesarean-section rates. Non-Hispanic whites had 20.6 of their births by cesarean section, compared with 19.2 percent among Asian Americans, 18.9 percent among blacks, and 13.9 percent among Mexican Americans. In all four of these groups, significant differences depending upon socioeconomic status were observed. Thus rates of cesaren section vary according to socioeconomic status and this cannot be accounted for by differences in maternal age, maternal history of giving birth to viable children, birth weight, race, ethnicity, or rates of complications of pregnancy and childbirth.

Economic aspects, Surgery, Cesarean section, Obstetrics

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Neonatal mortality in weekend vs weekday births

Article Abstract:

There is no evidence that babies born on the weekend in California hospitals are more likely to die than those born on weekday. This was the conclusion of a study of 1,615,041 births in California between 1995 and 1997. Other studies have shown that adults with a serious illness are more likely to die if admitted to a hospital on a weekend.

Demographic aspects, Infant mortality, Hospitalization, Hospital care, Week, Weeks

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Inadvertent use of Bicillin C-R to treat Syphilis infection-Los Angeles, California, 1999-2004

Article Abstract:

A report summarizing the investigation of the misuse of Bacilli C-R at the Los Angeles clinic, which represents the largest occurrence of inadvertent treatment with Bicillin C-R, is presented. Bicillin C-R is indicated for streptococcal infections of the skin and respiratory tract, however its efficacy in treating syphilis is unknown.

Science & research, Care and treatment, Research, Usage, Bacillus (Bacteria), Bacillus, Syphilis

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