Socioeconomic status and receipt of obstetric services in Canada
Socioeconomic status and receipt of obstetric services in Canada
复制标题
DOI：
10.1097/01.aog.0000201977.45284.3c
复制
发表时间：
2006-03-01
影响因子：
7.2
通讯作者：
Young, David C.
中科院分区：
文献类型：
--
作者：
Joseph, K. S.;Dodds, Linda;Young, David C.
目的：探讨加拿大新斯科舍省不同社会经济地位在引产率和剖宫产率方面的差异。方法：我们研究了加拿大新斯科舍省1988至1995年间单胎妊娠后分娩的所有妇女。信息来自加拿大统计局小区域和行政数据司维护的新斯科舍省围产期数据库和联邦所得税(T1)家庭档案(n=76,440)。结果：在最低收入组中，4.4%的妇女年龄在35岁及以上，49.4%的妇女是非吸烟者，而在最高收入组中，17.7%的妇女年龄在35岁或以上，88.7%的妇女不吸烟。不同收入组的粗引产率相似(17.7%与最高收入组相比，最低组为18.1%)，但粗剖宫产率(17.7%对21.2%)和粗初一次剖宫产率(12.5%对17.0%)有显著差异。控制风险因素的差异改变了这些关系。调整后的比率、95%可信区间(CLS)和与最高收入组相比最低的P值分别为：引产1.09(95%可信区间1.00~1.19)，P.05；总剖宫产率1.12(95%可信区间1.03~1.23)，P.01；初次剖宫产1.09(95%可信区间0.98~1.21)，P.12。
OBJECTIVE: To examine differences in labor induction and cesarean delivery rates by socioeconomic status in Nova Scotia, Canada.METHODS: 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.RESULTS: 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% confidence ifitervals (Cls) and P values contrasting the lowest compared with highest income groups were labor induction 1.09 (95% Cl 1.00-1.19), P.05; overall cesarean delivery 1.12 (95% Cl 1.03-1.23), P.01; primary cesarean delivery 1.09 (95% Cl 0.98-1.21), P.12.CONCLUSION: Affluent women in Canada are not more likely to have labor induction or cesarean delivery compared with less affluent women.