{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:53:04Z","timestamp":1773298384913,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objectives\u2003While bilateral tubal ligation has historically been performed for sterilization at cesarean delivery (CD), recent data supports the use and safety of opportunistic bilateral salpingectomy during CD to decrease lifetime ovarian cancer risk. Prior studies have described racial disparities in sterilization rates, but there is a paucity of data regarding racial disparities in type of sterilization procedure. Our objective was to determine differences in sterilization procedure type performed at CD by race (Black vs. non-Black) to evaluate for equity in bilateral salpingectomy utilization.<\/jats:p><jats:p>\n            Study Design\u2003We performed a retrospective cohort study of patients included in the American College of Surgeons National Surgical Quality Improvement Program database who underwent sterilization at time of CD from January 2019, to December 2020, identified using Current Procedural Terminology codes. Patients without documented race were excluded. Multivariable logistic regression was used to determine odds of undergoing bilateral salpingectomy compared with bilateral tubal ligation by race while controlling for confounders.<\/jats:p><jats:p>\n            Results\u2003Of 28,147 patients who underwent CD, 3,087 underwent concurrent sterilization procedure, and 2,161 met inclusion criteria (Black: n\u2009=\u2009279; non-Black: n\u2009=\u20091,882). Black patients were significantly more likely to have hypertension (10.8 vs. 5.3%, p\u2009&lt;\u20090.01), bleeding disorders (3.9 vs. 1.3%, p\u2009&lt;\u20090.01), preoperative anemia (hemoglobin\u2009&lt;\u200911\u2009g\/dL; 36.9 vs. 21.3%, p\u2009&lt;\u20090.01), and be of American Society of Anesthesiologist class 3 or higher (29.4 vs. 22.5%, p\u2009=\u20090.01) than non-Black patients. After adjusting for differences, Black patients were almost 50% less likely than non-Black patients to undergo bilateral salpingectomy compared with bilateral tubal ligation for sterilization at CD (adjusted odds ratio\u2009=\u20090.52, 95% confidence interval: 0.36\u20130.75).<\/jats:p><jats:p>\n            Conclusion\u2003Despite evidence that bilateral salpingectomy decreases ovarian cancer risk and is safe at CD, there is a racial disparity in bilateral salpingectomy utilization. While the cause of this disparity is unclear, further research is warranted to determine root causes and equitable solutions.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1974-9507","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T23:59:02Z","timestamp":1668038342000},"page":"e934-e938","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Racial Disparities in Sterilization Procedure Performed at Time of Cesarean Section"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-5472","authenticated-orcid":false,"given":"Lauren K.","family":"Walheim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher X.","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca F.","family":"Hamm","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref1","first-page":"648","volume-title":"Tubal sterilization","author":"A G Bryant","year":"2019"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"e194","DOI":"10.1097\/AOG.0000000000003111","article-title":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Gynecology. ACOG Practice Bulletin No. 208: benefits and risks of sterilization","volume":"133","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1097\/AOG.0000000000003165","article-title":"ACOG Committee Opinion No. 774: opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention","volume":"133","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.ajog.2020.09.011","article-title":"Salpingectomy vs tubal ligation for sterilization: A systematic review and meta-analysis","volume":"224","author":"K Mills","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0000000000002674","article-title":"Salpingectomy compared with tubal ligation at cesarean delivery","volume":"132","author":"C Garcia","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/AOG.0000000000003673","article-title":"Salpingectomy at the time of cesarean delivery: a systematic review and meta-analysis","volume":"135","author":"J T Roeckner","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"dju410","DOI":"10.1093\/jnci\/dju410","article-title":"Ovarian cancer risk after salpingectomy: a nationwide population-based study","volume":"107","author":"H Falconer","year":"2015","journal-title":"J Natl Cancer Inst"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/AOG.0000000000002312","article-title":"Salpingectomy for sterilization: change in practice in a large integrated health care system, 2011\u20132016","volume":"130","author":"C B Powell","year":"2017","journal-title":"Obstet 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2022","volume":"72","author":"R L Siegel","year":"2022","journal-title":"CA Cancer J Clin"},{"issue":"19","key":"ref15","doi-asserted-by":"crossref","first-page":"3548","DOI":"10.7150\/jca.26300","article-title":"Improved survival in ovarian cancer, with widening survival gaps of races and socioeconomic status: a period analysis, 1983\u20132012","volume":"9","author":"J Wu","year":"2018","journal-title":"J Cancer"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"101580","DOI":"10.1016\/j.canep.2019.101580","article-title":"Survival disparities among racial\/ethnic groups of women with ovarian cancer: an update on data from the surveillance, epidemiology and end results (SEER) registry","volume":"62","author":"A E Stenzel","year":"2019","journal-title":"Cancer Epidemiol"},{"issue":"11","key":"ref17","first-page":"e19729","article-title":"An update on racial and ethnic differences in neuraxial anesthesia for cesarean delivery","volume":"13","author":"B N Burton","year":"2021","journal-title":"Cureus"},{"issue":"04","key":"ref18","first-page":"565","article-title":"An elucidation of factors influencing physicians' willingness to perform elective female sterilization","volume":"72","author":"D D Harrison","year":"1988","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"319.e1","DOI":"10.1016\/j.ajog.2010.05.009","article-title":"Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race\/ethnicity and socioeconomic status","volume":"203","author":"C Dehlendorf","year":"2010","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"234.e1","DOI":"10.1016\/j.ajog.2021.09.010","article-title":"Primary prevention of ovarian cancer: a patient decision aid for opportunistic salpingectomy","volume":"226","author":"L AM van Lieshout","year":"2022","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1974-9507.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:18:01Z","timestamp":1730812681000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1974-9507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":18,"journal-issue":{"issue":"S 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