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

To describe differences in maternal admissions to the intensive care unit (ICU) and mortality in rural versus urban areas in the United States. We performed a nationwide analysis and calculated age-standardized rates and rate ratios (RRs) of maternal ICU admission and mortality per 100 000 live birt...

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Published inAmerican journal of public health (1971) Vol. 113; no. 2; pp. 224 - 227
Main Authors Harrington, Katharine A, Cameron, Natalie A, Culler, Kasen, Grobman, William A, Khan, Sadiya S
Format Journal Article
LanguageEnglish
Published United States American Public Health Association 01.02.2023
Subjects
Abortion
Age groups
Births
Family
Female
Hispanic people
Humans
Intensive care
Maternal and Infant Health
Maternal Mortality
Morbidity
Mortality
Obstetrics
Patient admissions
Pregnancy
Public health
Research & Analysis
Research Brief
Rural areas
Rural Health
Rural Population
Rural urban differences
Trends
United States - epidemiology
Urban areas
Urban Health
Urban Population
United States
United States > US
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Summary:To describe differences in maternal admissions to the intensive care unit (ICU) and mortality in rural versus urban areas in the United States. 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. 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 = 1.14; 95% confidence interval [CI] = 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 = 1.93; 95% CI = 1.71, 2.17). 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. Public health efforts need to focus on resource-limited rural areas to mitigate geographic disparities in maternal morbidity and mortality. ( 2023;113(2): 224-227.https://doi.org/10.2105/AJPH.2022.307134).
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K. A. Harrington completed the analyses and the first draft of the article. K. A. Harrington and S. S. Khan designed the study. N. A. Cameron, K. Culler, W. A. Grobman, and S. S Khan made critical revisions to the article. N. A. Cameron, W. A. Grobman, and S. S Khan supervised the analyses and contributed to the interpretation of the findings.
CONTRIBUTORS
ISSN:0090-0036
1541-0048
1541-0048
DOI:10.2105/AJPH.2022.307134