Race/ethnic differentials in heavy weight and cesarean births

Objectives: The general objectives of this research are to further our unde rstanding of the distribution and incidence of heavy weight births and to e xamine differentials in the use of cesarean section as a response to macros omia in models that are more broadly comparative by race/ethnicity than any that have heretofore been estimated. Methods: The data are drawn from the combined 1989-1991 NCHS Linked Birth/Infant Death Cohort Files, a data set of over 12 million live births and over 100,000 infant deaths that allows f or highly reliable estimations for relatively small race/ethnic sub populat ions. Results: The results confirm that previously identified determinants of macrosomia such as maternal diabetes, maternal weight gain, parity and a previous heavy weight infant are highly predictive of a macrosomic birth, independent of race/ethnic effects.. With respect to the management of heav y weight births, race/ethnic differentials exist in the odds of a cesarean delivery, the procedure most often used to limit the risks of a macrosomic delivery.