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

• Published in: American 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
• Language: English
• 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
• DOI: 10.2105/AJPH.2022.307134
• ISSN: 0090-0036; 1541-0048

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).