To compare rural obstetric patient and neonate characteristics and outcomes by birth location.
Retrospective observational cohort study of rural residents’ hospital births from California, Pennsylvania, and South Carolina. Hospitals in rural counties were rural-located, those in metropolitan counties with ≥10% of obstetric patients from rural communities were rural-serving, metropolitan-located, others were non-rural-serving, metropolitan-located. Any adverse obstetric patient or neonatal outcomes were assessed with logistic regression accounting for patient characteristics, state, year, and hospital.
Of 466,896 rural patient births, 64.3% occurred in rural-located, 22.5% in rural-serving, metropolitan-located, and 13.1% in non-rural-serving, metropolitan-located hospitals. The odds of any adverse outcome increased in rural-serving (aOR 1.27, 95% CI 1.10–1.46) and non-rural-serving (aOR 1.35, 95% CI 1.18–1.55) metropolitan-located hospitals.
One-third of rural obstetric patients received care in metropolitan-located hospitals. These patients have higher comorbidity rates and higher odds of adverse outcomes likely reflecting referral for higher baseline illness severity.
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Data generated and analyzed during the current study are not publicly available due to data use agreements, but may be available from the senior author on reasonable request.
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Handley, S.C., Passarella, M., Interrante, J.D. et al. Perinatal outcomes for rural obstetric patients and neonates in rural-located and metropolitan-located hospitals. J Perinatol (2022). https://doi.org/10.1038/s41372-022-01490-7