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  • Title: Factors associated with high-risk rural women giving birth in non-NICU hospital settings.
    Author: Kozhimannil KB, Hung P, Casey MM, Lorch SA.
    Journal: J Perinatol; 2016 Jul; 36(7):510-5. PubMed ID: 26890556.
    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.
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