{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:18:21Z","timestamp":1784542701640,"version":"3.55.0"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>\n            Objective\u2003Delivery of very preterm and very low birth weight neonates (VPT\/VLBW) in a nonlevel III neonatal intensive care unit (NICU) increases risk of morbidity and mortality. Study objectives included the following: (1) Determine incidence of VPT\/VLBW delivery (&lt;32 weeks gestational age and\/or birth weight &lt;1,500\u2009g), in nonlevel III units in Colorado; (2) Evaluate the independent association between residence and nonlevel III unit delivery; (3) Determine the incidence of and factors associated with postnatal transfer.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective cohort study used 2007 to 2016 Colorado birth certificate data. Demographic and clinical characteristics by VPT\/VLBW delivery in level III NICUs versus nonlevel III units were compared using Chi-square analyses. Multivariable logistic regression was used to estimate the independent association between residence and VPT\/VLBW delivery.<\/jats:p><jats:p>\n            Results\u2003Among patients, 897 of 10,015 (8.96%) VPT\/VLBW births occurred in nonlevel III units. Compared with infants born to pregnant persons in urban counties, infants born to those residing in rural (adjusted odds ratio [AOR]\u2009=\u20091.58, 95% confidence interval [CI]: 1.33, 1.88) or frontier (AOR\u2009=\u20093.19, 95% CI: 2.14, 4.75) counties were more likely to deliver in nonlevel III units and to experience postnatal transfer within 24\u2009hours (rural AOR\u2009=\u20092.24, 95% CI: 1.60, 3.15; frontier AOR\u2009=\u20093.91, 95% CI: 1.76, 8.67). Compared with non-Hispanic Whites, Hispanics were more likely to deliver VPT\/VLBW infants in nonlevel III units (AOR\u2009=\u20091.36, 95% CI: 1.15, 1.61).<\/jats:p><jats:p>\n            Conclusion\u2003A significant number of VPT\/VLBW neonates were born in nonlevel III units with associated disparities by race\/ethnicity and nonurban residence.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1727222","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T23:41:49Z","timestamp":1618962109000},"page":"035-041","source":"Crossref","is-referenced-by-count":3,"title":["Association of Rural and Frontier Residence with Very Preterm and Very Low Birth Weight Delivery in Nonlevel III NICUs"],"prefix":"10.1055","volume":"40","author":[{"given":"Stephanie L.","family":"Bourque","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair W.","family":"Weikel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Crispe","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunah S.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"issue":"04","key":"ref2","first-page":"375","article-title":"Toward improving the outcome of pregnancy recommendations for the regional 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