K B Kozhimannil1, P Hung1, M M Casey1, S A Lorch2. 1. University of Minnesota Rural Health Research Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA. 2. Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Abstract
OBJECTIVE: To identify risk factors for childbirth in a facility without neonatal intensive care unit (NICU) capacity among high-risk rural women. STUDY DESIGN: Using data on all maternal hospitalizations for rural residents in nine states (2010, 2012), we performed logit regression, focusing on women with multiple gestation and preterm birth. We defined a 'local' hospital as any maternity hospital within 30 miles (or the nearest hospital). RESULTS: Rural women with preterm births and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity. Adjusted odds of giving birth in a NICU hospital were lower among women ⩽age 20 (AOR 0.87 (95% CI 0.77, 0.98)), Medicaid beneficiaries (0.81 (0.75, 0.89)), uninsured women (0.44 (0.32, 0.61)) and black women (0.60 (0.50, 0.71)). CONCLUSIONS: Among high-risk rural pregnant women without local NICU access, younger, low-income, and black women had lower odds of using NICU hospitals.
OBJECTIVE: To identify risk factors for childbirth in a facility without neonatal intensive care unit (NICU) capacity among high-risk rural women. STUDY DESIGN: Using data on all maternal hospitalizations for rural residents in nine states (2010, 2012), we performed logit regression, focusing on women with multiple gestation and preterm birth. We defined a 'local' hospital as any maternity hospital within 30 miles (or the nearest hospital). RESULTS: Rural women with preterm births and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity. Adjusted odds of giving birth in a NICU hospital were lower among women ⩽age 20 (AOR 0.87 (95% CI 0.77, 0.98)), Medicaid beneficiaries (0.81 (0.75, 0.89)), uninsured women (0.44 (0.32, 0.61)) and black women (0.60 (0.50, 0.71)). CONCLUSIONS: Among high-risk rural pregnant women without local NICU access, younger, low-income, and black women had lower odds of using NICU hospitals.
Authors: Elena V Kuklina; Maura K Whiteman; Susan D Hillis; Denise J Jamieson; Susan F Meikle; Samuel F Posner; Polly A Marchbanks Journal: Matern Child Health J Date: 2007-08-10
Authors: Gwieneverea D Brandon; Susan Adeniyi-Jones; Sharon Kirkby; David Webb; Jennifer F Culhane; Jay S Greenspan Journal: Pediatrics Date: 2009-07 Impact factor: 7.124
Authors: Nancy D Berkman; Stacey L Sheridan; Katrina E Donahue; David J Halpern; Karen Crotty Journal: Ann Intern Med Date: 2011-07-19 Impact factor: 25.391
Authors: M Kathryn Menard; Sarah Kilpatrick; George Saade; Lisa M Hollier; Gerald F Joseph; Wanda Barfield; William Callaghan; John Jennings; Jeanne Conry Journal: Am J Obstet Gynecol Date: 2015-01-22 Impact factor: 8.661