Race and vaginal birth after cesarean delivery in a military population.
Publication Status: Published
Sponsoring Organization: Navy
Sponsoring Office: Naval Medical Center San Diego
Congressionally Mandated: No
Funding Source: Undetermined
Release Date/Publication: May 01, 2014
Principle Investigator Status: Government
Primary DoD Data Source: Military Health System (MHS) Data Repository
Secondary DoD Data Source:
Abstract
INTRODUCTION: The objective of this study was to determine if race is associated with vaginal birth after cesarean delivery (VBAC) success in a military population.
METHODS: A retrospective cohort study was conducted examining women with a history of at least one prior cesarean delivery who delivered at a single tertiary care military treatment facility. Data were collected pertaining to maternal demographics, medical and obstetric history, antepartum complications, intrapartum course, delivery mode, and maternal outcomes. Univariable and multivariable analyses were used to determine the association of race and VBAC success.
RESULTS: Four hundred seventy-six charts were reviewed from 2004 to 2011. African American women were more likely to require a cesarean delivery (P<.05) even after adjusting for potentially confounding factors. There was no difference in maternal morbidity between the racial groups.
CONCLUSIONS: In a health care system with equal access, racial disparities remain. The effect of social factors that may influence such a disparity are thought to be attenuated in a military population. However, in our study, African American women were still significantly more likely to fail a VBAC attempt as compared with non-African American women. Race had no influence on morbidity, although this study was not powered to examine morbidity as a primary outcome.
Citation:
Brankin C, Stratton S, Piszczek C, You W. Race and vaginal birth after cesarean delivery in a military population. Obstet Gynecol. 2014 May;123 Suppl 1:139S.