Rural–Urban Disparities in Adverse Maternal Outcomes in the United States, 2016–2019

Katharine A. Harrington, Natalie A. Cameron, Kasen Culler, William A. Grobman, Sadiya S. Khan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives. To describe differences in maternal admissions to the intensive care unit (ICU) and mortality in rural versus urban areas in the United States. Methods. We performed a nationwide analysis and calculated age-standardized rates and rate ratios (RRs) of maternal ICU admission and mortality per 100 000 live births between 2016 and 2019 in rural versus urban areas. Results. From 2016 to 2019, there was no significant increase in age-standardized rates of maternal ICU admissions in rural (170.6–192.3) or urban (161.7–172.4) areas, with a significantly higher rate, albeit a relatively small difference, in rural versus urban areas (2019 RR 5 1.14; 95% confidence interval [CI] 5 1.04, 1.20). Maternal mortality increased in both rural (66.9–81.7 deaths per 100 000 live births) and urban (38.1–42.3) areas and was nearly 2 times higher in rural areas (2019 RR 5 1.93; 95% CI 5 1.71, 2.17). Conclusions. Pregnant individuals in rural areas are at higher risk for ICU admission and mortality than are their urban counterparts. Significant increases in maternal mortality occurred in rural and urban areas.

Original languageEnglish (US)
Pages (from-to)224-227
Number of pages4
JournalAmerican journal of public health
Issue number2
StatePublished - Feb 2023

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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