Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986–2012

a total population-based study

F. Thompson, K. Dempsey, G. Mishra

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers. 

    Design: Total population-based study. Setting: Northern Territory of Australia, 1986–2012. Population: Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37–42 weeks’ gestation (n = 78 561). 

    Methods: Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. 

    Main outcome measures: Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. 

    Results: The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34–1.60)]. 

    Conclusions: Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers. 

    Tweetable abstract: Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.

    Original languageEnglish
    Pages (from-to)1814-1823
    Number of pages10
    JournalBJOG: an International Journal of Obstetrics and Gynaecology
    Volume123
    Issue number11
    DOIs
    Publication statusPublished - 1 Oct 2016

    Fingerprint

    Northern Territory
    Cesarean Section
    Parturition
    Obstetrics
    Population
    Demography
    Pregnancy
    Live Birth
    Odds Ratio
    Head
    Outcome Assessment (Health Care)

    Cite this

    @article{5006c1931ff0495380f003f32204db0c,
    title = "Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986–2012: a total population-based study",
    abstract = "Objective: To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers. Design: Total population-based study. Setting: Northern Territory of Australia, 1986–2012. Population: Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37–42 weeks’ gestation (n = 78 561). Methods: Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. Main outcome measures: Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. Results: The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47{\%} greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95{\%} CI 1.34–1.60)]. Conclusions: Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers. Tweetable abstract: Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.",
    keywords = "Caesarean section, Indigenous, trends",
    author = "F. Thompson and K. Dempsey and G. Mishra",
    year = "2016",
    month = "10",
    day = "1",
    doi = "10.1111/1471-0528.13881",
    language = "English",
    volume = "123",
    pages = "1814--1823",
    journal = "BJOG: an International Journal of Obstetrics and Gynaecology",
    issn = "1470-0328",
    publisher = "Wiley-Blackwell",
    number = "11",

    }

    Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986–2012 : a total population-based study. / Thompson, F.; Dempsey, K.; Mishra, G.

    In: BJOG: an International Journal of Obstetrics and Gynaecology, Vol. 123, No. 11, 01.10.2016, p. 1814-1823.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986–2012

    T2 - a total population-based study

    AU - Thompson, F.

    AU - Dempsey, K.

    AU - Mishra, G.

    PY - 2016/10/1

    Y1 - 2016/10/1

    N2 - Objective: To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers. Design: Total population-based study. Setting: Northern Territory of Australia, 1986–2012. Population: Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37–42 weeks’ gestation (n = 78 561). Methods: Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. Main outcome measures: Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. Results: The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34–1.60)]. Conclusions: Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers. Tweetable abstract: Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.

    AB - Objective: To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers. Design: Total population-based study. Setting: Northern Territory of Australia, 1986–2012. Population: Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37–42 weeks’ gestation (n = 78 561). Methods: Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. Main outcome measures: Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. Results: The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34–1.60)]. Conclusions: Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers. Tweetable abstract: Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.

    KW - Caesarean section

    KW - Indigenous

    KW - trends

    UR - http://www.scopus.com/inward/record.url?scp=84988443435&partnerID=8YFLogxK

    U2 - 10.1111/1471-0528.13881

    DO - 10.1111/1471-0528.13881

    M3 - Article

    VL - 123

    SP - 1814

    EP - 1823

    JO - BJOG: an International Journal of Obstetrics and Gynaecology

    JF - BJOG: an International Journal of Obstetrics and Gynaecology

    SN - 1470-0328

    IS - 11

    ER -