Title

Perinatal outcomes for rural obstetric patients and neonates in rural-located and metropolitan-located hospitals.

Year of Publication

2022

Author

Date Published

08/2022

ISSN Number

1476-5543

Abstract

OBJECTIVE: To compare rural obstetric patient and neonate characteristics and outcomes by birth location.

METHODS: Retrospective observational cohort study of rural residents' hospital births from California, Pennsylvania, and South Carolina. Hospitals in rural counties were rural-located, those in metropolitan counties with ≥10% of obstetric patients from rural communities were rural-serving, metropolitan-located, others were non-rural-serving, metropolitan-located. Any adverse obstetric patient or neonatal outcomes were assessed with logistic regression accounting for patient characteristics, state, year, and hospital.

RESULTS: Of 466,896 rural patient births, 64.3% occurred in rural-located, 22.5% in rural-serving, metropolitan-located, and 13.1% in non-rural-serving, metropolitan-located hospitals. The odds of any adverse outcome increased in rural-serving (aOR 1.27, 95% CI 1.10-1.46) and non-rural-serving (aOR 1.35, 95% CI 1.18-1.55) metropolitan-located hospitals.

CONCLUSION: One-third of rural obstetric patients received care in metropolitan-located hospitals. These patients have higher comorbidity rates and higher odds of adverse outcomes likely reflecting referral for higher baseline illness severity.

DOI

10.1038/s41372-022-01490-7

Alternate Title

J Perinatol

PMID

35963889