Journal of Perinatology advance online publication 18 February 2016;
doi: 10.1038/jp.2016.8
Factors associated with high-risk rural women giving birth in non-NICUhospital settings
Kozhimannil,Hung and Lorch
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.