United States rural residence is associated with increased acute maternal end-organ injury or mortality after birth: a retrospective multi-state analysis, 2007–2018
Authors' conclusion
Rural-urban disparities in maternal end-organ damage and mortality exist and anesthesia choice may play an important role in these disparate outcomes.
Study context
- Population
- Women giving birth (cesarean or vaginal), US multi-state data, by county of residence
- Exposure
- Rural and other non-central residence vs central metropolitan residence
- Outcome
- Composite of:
- Maternal end-organ injury
- Inpatient mortality
Methodological detailsmulti-state
- Multi-state
Main finding
As reported in the abstract
Each group vs central metropolitanOdds ratio (95% CI)
Micropolitan
1.17(1.09–1.27)
Non-metropolitan or micropolitan
1.14(1.04–1.24)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Vaginal birth without neuraxial analgesiaMicropolitan vs Central metropolitan | 2.07 (2.02–2.12) | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Vaginal birth without neuraxial analgesiaNon-metropolitan or micropolitan vs Central metropolitan | 2.25 (95% CI 2.16–2.34) |
GA (vs neuraxial) for cesarean birth
- Suburban, medium and small metropolitan residents underwent GA less often during cesarean births than urban residents
Original publication
United States rural residence is associated with increased acute maternal end-organ injury or mortality after birth: a retrospective multi-state analysis, 2007–2018. Int J Obstet Anesth. Published 3 August 2023. doi:10.
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