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J Perinatol. 2016 Jul;36(7):510-5. doi: 10.1038/jp.2016.8. Epub 2016 Feb 18.

Factors associated with high-risk rural women giving birth in non-NICU hospital settings.

Author information

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 ÔęŻage 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.

PMID:
26890556
DOI:
10.1038/jp.2016.8
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