Abstract
Objectives Does the incidence and/or indication(s) for emergency cesarean section differ if
the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency
(communication problems) and a low acculturation level result in a longer decision-to-delivery
interval (D-D interval)? Are neonates born to women with IB by emergency cesarean
section in a poorer condition post delivery?
Patient cohorts and method Standardized interviews were carried out before or immediately after delivery in
three Berlin obstetric hospitals. Questions were asked about the sociodemographic
background and care aspects as well as about immigration and level of acculturation.
Collected data were linked to information obtained from the expectant motherʼs antenatal
records and to care data and perinatal data routinely recorded by the hospitals. Data
was analyzed using regression models which adjusted for age, parity, and socio-economic
status.
Results The total patient population consisted of 7100 women (rate of response: 89.6%); of
these women, 111 required emergency cesarean section (50 women without IB, 61 immigrant
women). Risk factors such as late first antenatal check-up, gestational diabetes,
pregnancy-induced hypertension, fetal macrosomia, smoking, and weight gain were similar
in both patient cohorts. The incidence of and indications for emergency cesarean section
and the D-D interval were similar for both groups. Limited German language proficiency
and low levels of acculturation among immigrant women did not prolong the D-D interval.
There were no statistically relevant differences between immigrant and non-immigrant
cohorts with regard to adverse neonatal conditions (5-minute Apgar score ≤ 7, umbilical
cord arterial pH < 7.00) or with regard to immediate transfer of the neonate to a
pediatric clinic following emergency cesarean section.
Conclusion The factor “immigrant background” did not affect the indication or obstetric outcome
following emergency cesarean section.
Key words cesarean section - emergency cesarean section - immigrant women - perinatal outcome
