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

Journal of Perinatology volume 36, pages 510–515 (2016)Cite this article

Subjects

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.

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Acknowledgements

This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), US Department of Health and Human Services (HHS) under PHS Grant No. 5U1CRH03717. The information, conclusions and opinions expressed in this manuscript are those of the authors and no endorsement by FORHP, HRSA or HHS is intended or should be inferred.

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Authors and Affiliations

  1. Division of Health Policy and Management, University of Minnesota Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, MN, USA

    K B Kozhimannil, P Hung & M M Casey

  2. Children’s Hospital of Philadelphia, , Philadelphia, PA, USA

    S A Lorch

Authors
  1. K B Kozhimannil
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  2. P Hung
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  3. M M Casey
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  4. S A Lorch
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Corresponding author

Correspondence to K B Kozhimannil.

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The authors have no financial relationships relevant to this article to disclose.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Kozhimannil, K., Hung, P., Casey, M. et al. Factors associated with high-risk rural women giving birth in non-NICU hospital settings. J Perinatol 36, 510–515 (2016). https://doi.org/10.1038/jp.2016.8

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