Assessing Racial/Ethnic Variation and Trends in Vaginal Birth after Cesarean in California: A Retrospective Cohort Study Using Linked Birth Certificate and Hospital Discharge Records
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Le résumé fourni par la source
Abstract Increasing the vaginal birth after cesarean (VBAC) rate to 18% was a Healthy People 2020 goal. Detailed data on racial/ethnic differences in VBAC rates is lacking and can inform efforts to equitably increase VBAC rates. This study aimed to assess racial/ethnic variation in VBAC rates and to describe group trends in VBAC rates in California between 2011 and 2021. This retrospective cohort study used a database of birth certificates linked to hospital discharge records. We analyzed singleton, term live births among people who had a history of at least one prior cesarean birth, no identified contraindications to a vaginal birth, and self-identified their racial/ethnic group as Hispanic or non-Hispanic (American Indian-Alaskan Native (AIAN), Asian, Black, Hawaiian/Pacific Islander, or white). VBAC births were identified from birth certificate records. Differences between VBAC rates were assessed using univariable and multivariable Poisson log-linear regression while adjusting for potential confounders. A total of 607,808 birthing people were included (2,234 AIAN, 84,899 Asian, 34,217 Black, 2,559 Hawaiian/Pacific Islander, 334,116 Hispanic, 149,783 white). Over the study period, Hawaiian/Pacific Islander birthing people had the highest average VBAC rate at 11.5% (AIAN, 6.5%; Asian, 8.8%; Black, 8.0%; Hispanic, 7.4%; white, 9.5%). In adjusted models, Black (aRR = 1.06, 95% CI: 1.01–1.11) and Hawaiian/Pacific Islander (aRR = 1.43, 95% CI: 1.27–1.61) birthing people were more likely to have a VBAC compared with white birthing people, while Hispanic birthing people were less likely (aRR = 0.96, 95% CI: 0.93–0.98). VBAC rates increased significantly (p < 0.001) over time for all groups except AIAN birthing people. VBAC rates increased for most racial/ethnic groups in California. With the exception of the Hawaiian/Pacific Islander group, there were small and likely not clinically significant differences in the chances for a VBAC across groups. No group in California met the Healthy People 2020 goal VBAC rate of 18%.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Assessing Racial/Ethnic Variation and Trends in Vaginal Birth after Cesarean in California: A Retrospective Cohort Study Using Linked Birth Certificate and Hospital Discharge Records
- Date Crossref
- 12/05/2025
- Éditeur
- Georg Thieme Verlag KG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of California Division of Ob/Gyn Hospital Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego pays non établi dans la noticeUniversité ou école supérieure
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University of British Columbia pays non établi dans la noticeUniversité ou école supérieure
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Global Brain Health Institute pays non établi dans la noticeOrganisation à but non lucratif
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New York University pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Medicine Birth Place Lab pays non établi dans la noticeUniversité ou école supérieure
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School of Population and Public Health pays non établi dans la noticeUniversité ou école supérieure
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Harvard TH Chan School of Public Health Department of Health Policy and Management pays non établi dans la noticeUniversité ou école supérieure
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Mory Meyers College of Nursing pays non établi dans la noticeUniversité ou école supérieure
Division of Ob/Gyn Hospital Medicine — University of California, University of California San Diego et University of British Columbia, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.