TY - JOUR
T1 - Associations between maternal residential rurality and maternal health, access to care, and very low birthweight infant outcomes
AU - Ondusko, Devlynne S.
AU - Liu, Jessica
AU - Hatch, Brigit
AU - Profit, Jochen
AU - Carter, Emily Hawkins
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2022/12
Y1 - 2022/12
N2 - Objective: Infant mortality is increased in isolated rural areas. This study compares prenatal factors, access to care, and health outcomes for very-low birthweight (VLBW) infants by degree of maternal residential rurality. Methods: This descriptive population-based retrospective cohort study used the California Perinatal Quality Care Collaborative registry to study VLBW infants. Rurality was assigned as urban, large rural, and small rural/isolated using the Rural Urban Commuting Area codes. We used hierarchical random effect models to test the association of rurality with survival without major morbidity. Results: The study included 38 614 dyads. VLBW survival without major morbidity decreased with increasing rurality and the relationship remained significant for small rural/isolated areas (OR 0.79, p = 0.03) after adjustment. Birth weight, gestational age, and infant sex were similar across geographic groups. Conclusion: A rural urban disparity exists for VLBW survival without major morbidity. Our findings generate hypotheses about factors that may be driving these disparities.
AB - Objective: Infant mortality is increased in isolated rural areas. This study compares prenatal factors, access to care, and health outcomes for very-low birthweight (VLBW) infants by degree of maternal residential rurality. Methods: This descriptive population-based retrospective cohort study used the California Perinatal Quality Care Collaborative registry to study VLBW infants. Rurality was assigned as urban, large rural, and small rural/isolated using the Rural Urban Commuting Area codes. We used hierarchical random effect models to test the association of rurality with survival without major morbidity. Results: The study included 38 614 dyads. VLBW survival without major morbidity decreased with increasing rurality and the relationship remained significant for small rural/isolated areas (OR 0.79, p = 0.03) after adjustment. Birth weight, gestational age, and infant sex were similar across geographic groups. Conclusion: A rural urban disparity exists for VLBW survival without major morbidity. Our findings generate hypotheses about factors that may be driving these disparities.
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U2 - 10.1038/s41372-022-01456-9
DO - 10.1038/s41372-022-01456-9
M3 - Article
C2 - 35821103
AN - SCOPUS:85134251773
SN - 0743-8346
VL - 42
SP - 1592
EP - 1599
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 12
ER -