Socioeconomic status and receipt of obstetric services in Canada

Obstetrics and Gynecology
K S JosephDavid C Young

Abstract

To examine differences in labor induction and cesarean delivery rates by socioeconomic status in Nova Scotia, Canada. We studied all women in Nova Scotia who delivered between 1988 and 1995 after a singleton pregnancy. Information was obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax (T1) Family Files maintained by the Small Area and Administrative Data Division of Statistics Canada (n = 76,440). Labor induction and cesarean delivery rates were contrasted by family income and other indices, with adjustment for risk factors carried out using logistic models. Maternal characteristics and other factors varied by socioeconomic status; in the lowest income group 4.4% of women were aged 35 years or older, and 49.4% were nonsmokers, whereas in the highest income group 17.7% were aged 35 years or older, and 88.7% were nonsmokers. Crude induction rates were similar across income groups (17.7% compared with 18.1% in the lowest compared with highest income groups), but there were significant differences in crude cesarean (17.7% compared with 21.2%) and crude primary cesarean rates (12.5% compared with 17.0%). Controlling for differences in risk factors altered these relationships. Adjusted rate ratios, 95% ...Continue Reading

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Citations

Sep 12, 2007·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·K S JosephAlexander C Allen
Apr 4, 2012·International Journal of Environmental Research and Public Health·Igor BurstynPaul Veugelers
Jan 15, 2014·BMC Pregnancy and Childbirth·Jennifer E LutomskiRichard A Greene
Mar 29, 2014·BMC Pregnancy and Childbirth·K S JosephAlexander C Allen
Jun 16, 2009·Paediatric and Perinatal Epidemiology·Michael S KramerUNKNOWN Montreal Prematurity Study Group
Apr 16, 2013·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Michelle R WiseLynn Sadler
May 18, 2013·Archives of Disease in Childhood·Kelli FlemmingStefan Kuhle
Sep 21, 2019·Journal of Autism and Developmental Disorders·Sepideh SaroukhaniMohammad H Rahbar
Feb 23, 2020·Obstetrics and Gynecology·Catherine SmithK S Joseph
Mar 12, 2018·Health Economics Review·Carine Milcent, Saad Zbiri

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