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

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

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Delivery, Obstetric / economics*
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Hospitals, Maternity / statistics & numerical data*
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Logistic Models
  • Male
  • Medicaid
  • Medically Uninsured
  • Perinatology
  • Pregnancy
  • Premature Birth / epidemiology*
  • Rural Population
  • Socioeconomic Factors
  • United States
  • Young Adult