TY - JOUR
T1 - Rural–Urban Disparities in Adverse Maternal Outcomes in the United States, 2016–2019
AU - Harrington, Katharine A.
AU - Cameron, Natalie A.
AU - Culler, Kasen
AU - Grobman, William A.
AU - Khan, Sadiya S.
N1 - Funding Information:
S. S. Khan received funding from the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH; grant NHLBI HL161514).
Publisher Copyright:
© 2023 American Public Health Association Inc.. All rights reserved.
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
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U2 - 10.2105/AJPH.2022.307134
DO - 10.2105/AJPH.2022.307134
M3 - Article
C2 - 36652639
AN - SCOPUS:85146486064
SN - 0090-0036
VL - 113
SP - 224
EP - 227
JO - American journal of public health
JF - American journal of public health
IS - 2
ER -
