{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T01:59:17Z","timestamp":1769911157115,"version":"3.49.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003We compared differences in perinatal outcomes among rural and nonrural women, stratified by maternal race\/ethnicity. We also examined differences between majority minority rural counties with majority White rural counties.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a retrospective cohort study with 2015 national vital statistics birth certificate data. Maternal county of residence was identified, and counties with &lt;50,000 people were designated as rural. We compared adverse perinatal outcomes between rural and nonrural residents, stratified by race\/ethnicity. Adverse perinatal outcomes included primary term cesarean, preterm birth (PTB) &lt;37 and &lt;32 weeks, neonatal intensive care unit (NICU) admissions, infant death, small for gestational age, and Apgar's scores &lt;7 and &lt;3 at 5minutes. Majority\u2013minority rural counties were defined as counties having &lt;50% White women. We compared perinatal outcomes among this cohort to those of women from majority White rural counties. Bivariate analysis and multivariable logistic regression were performed.<\/jats:p><jats:p>\n            Results\u2003Within the entire cohort, rural residents were more likely to be younger (age \u226535 years, 10.1 vs. 16.8%; p&lt;0.001), Medicaid beneficiaries (50.3 vs. 44.1%; p&lt;0.001), and uninsured (6.6 vs. 4.2%; p&lt;0.001), and less likely to be married (57.4 vs. 60.20%; p&lt;0.001). Rural residence was associated with Apgar's score &lt;7 (adjusted odds ratio [aOR]=2.04; 95% confidence interval [CI]: 1.64\u20132.54) and &lt;3 (aOR=1.90; 95% CI: 1.04\u20133.48) among Asian women. Rural residence was also associated with PTB &lt;37 weeks among Black (aOR=1.09; 95% CI: 1.06\u20131.13) and Asian women (aOR=1.16; 95% CI: 1.03\u20131.31). When compared with majority White rural county of residence, majority\u2013minority rural county of residence was associated with the adverse perinatal outcomes studied.<\/jats:p><jats:p>\n            Conclusion\u2003We observed increased rates of adverse perinatal outcomes among rural women. These trends persisted in majority\u2013minority rural. Additional study is needed to find actionable targets for improving outcomes for rural women.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1878-0204","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T22:36:47Z","timestamp":1655419007000},"page":"e249-e258","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Differences in Perinatal Outcomes among Rural Women by County Composition"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7439-9021","authenticated-orcid":false,"given":"Osinakachukwu","family":"Mbata","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharti","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron B.","family":"Caughey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel A.","family":"Pilliod","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6602a1","article-title":"Reducing potentially excess deaths from the five leading causes of death in the rural United States","volume":"66","author":"M C Garcia","year":"2017","journal-title":"MMWR Surveill 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