Association between Hospital Birth Volume and Maternal Morbidity among Low-Risk Pregnancies in Rural, Urban, and Teaching Hospitals in the United States

Kozhimannil, Katy B.; Thao, Viengneesee; Hung, Peiyin; Tilden, Ellen L.; Caughey, Aaron B.; Snowden, Jonathan M.

doi:10.1055/s-0035-1570380

Cited by 48 publications

(12 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postpartum hemorrhage (PPH) found to be more common in this study. Other studies reported the proportion as 24% in Italy [18], 12.5% in Brazil [19], 9% in Uganda [20], 4.2% in Nigeria [21], and 0.3% in the USA [22]. Large-scale and multicenter studies reported small proportion, whereas small-scale studies reported higher proportion, and the difference could be explained by sample size.…”

Section: Discussionmentioning

confidence: 99%

Outcomes among Mothers Who Gave Birth in the Health Facility: Does Birth Preparedness and Complication Readiness Have a Role?

Gudayu

Araya

2019

Obstetrics and Gynecology International

View full text Add to dashboard Cite

Background. Giving childbirth is a natural reward for human beings to replace themselves to exist in the world. Despite all the efforts made to improve maternal health, maternal morbidity and mortality continue during childbirth. Hence, this study aimed to determine the proportion of maternal birth outcomes and identify their predictors among mothers who gave birth in hospitals. Method. A hospital-based cross-sectional study was conducted from April 9 to June 7, 2016, among 384 postnatal mothers in Debre Tabor Hospital. Randomly selected mothers were interviewed by trained data collectors. Data were checked for completeness, entered using Epi Info version 7, and analyzed using STATA 14 software. A multivariate logistic regression model was used to control confounders and identify predictors of maternal birth outcomes. Statistical significance was declared by adjusted odds ratio with a 95% confidence interval and a p value ≤0.05. Result. About 77% (95% CI: 72.9, 81.3) of the mothers had good maternal birth outcomes. Antenatal care utilization (AOR: 2.60; 95% CI: 1.16, 5.83); BPCR practice (AOR: 2.10; 95% CI: 1.12, 3.96); self-preference of health institution (AOR: 2.34; 95% CI: 1.11, 4.50); and mode of delivery: caesarean (AOR: 0.46; 95% CI: 0.23, 0.87), assisted breech (AOR: 0.17; 95% CI: 0.04, 0.69), and instrumental (AOR: 0.27; 95% CI: 0.09, 0.79) were associated with good maternal birth outcome. Conclusion. In this study, the maternal birth outcome among postnatal mothers was good in more than three-fourth of the cases. Hence, encouraging mothers to utilize health-care services and counseling and supporting them on BPCR practice are recommended.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes among Mothers Who Gave Birth in the Health Facility: Does Birth Preparedness and Complication Readiness Have a Role?

Gudayu

Araya

2019

Obstetrics and Gynecology International

View full text Add to dashboard Cite

show abstract

“…12,24 Teaching hospitals may have greater resources and capacity to diagnose and treat highly complex or rare conditions. [24][25][26] Research and clinical initiatives related to maternal OUD and NAS-even those focused on rural communitiesare predominantly housed in urban teaching hospitals with expertise in these conditions. 14,27,28 Yet, some rural residents-even those with OUD and other complex clinical conditions-give birth locally, and rural hospitals have to be prepared to either transfer or care for these patients and their infants, including those who develop NAS.…”

mentioning

confidence: 99%

Maternal Opioid Use Disorder and Neonatal Abstinence Syndrome Among Rural US Residents, 2007–2014

Kozhimannil

Chantarat

Ecklund

et al. 2018

The Journal of Rural Health

View full text Add to dashboard Cite

Purpose Opioid use disorder (OUD) during pregnancy is associated with poor maternal and infant outcomes, including neonatal abstinence syndrome (NAS), and both maternal OUD and NAS are increasing disproportionately among rural residents. This study describes the trajectory and characteristics associated with diagnosis of maternal OUD or NAS among rural residents who gave birth at different types of hospitals based on rural/urban location and teaching status. Methods Hospital discharge data from the all‐payer National Inpatient Sample were used to describe maternal OUD and infant NAS among rural residents from 2007–2014. Hospitals were categorized as rural, urban teaching, and urban nonteaching. We estimated incidence trends by hospital categories, followed by multivariable logistic regression analyses to identify correlates of OUD and NAS among rural residents, stratified by hospital category. Findings Incidence of maternal OUD increased in all hospital categories, with higher rates (8.9/1,000 deliveries) among rural residents who gave birth at urban teaching hospitals compared with those who gave birth at rural hospitals (4.3/1,000 deliveries) or urban nonteaching hospitals (3.6/1,000 deliveries; P < .001). A similar pattern was observed for infant NAS. In multivariable models, the association between maternal OUD and infant NAS diagnoses and hospital category differed by rurality (micropolitan vs. noncore.) Conclusions There has been a sustained increase in both maternal OUD and NAS diagnoses among rural residents. Measured sociodemographic and clinical correlates of maternal OUD and NAS differ by hospital category, indicating variability across hospital locations in patient populations and clinical needs for rural residents with these conditions.

show abstract

“…Both populations of childbearing families in this study, rural/small town and urban/suburban, surpassed national benchmarks for selected quality measures. Although maternal and neonatal health inequities are well documented in rural America, [5][6][7][8][9][10][11][12][13] findings from this project tell a different story-one of population health, strength, and resilience associated with community midwifery care. Controlling for medical risk factors and when matched with the appropriate level of care, rural childbearing families have equal and in some cases better outcomes than those living in urban settings.…”

Section: Discussionmentioning

confidence: 99%

Rural resilience: The role of birth centers in the United States

Jolles

Stapleton²,

Wright³

et al. 2020

Birth

View full text Add to dashboard Cite

Purpose To explore the role of the birth center model of care in rural health and maternity care delivery in the United States. Methods All childbearing families enrolled in care at an American Association of Birth Centers Perinatal Data RegistryTM user sites between 2012 and 2020 are included in this descriptive analysis. Findings Between 2012 and 2020, 88 574 childbearing families enrolled in care with 82 American Association of Birth Centers Perinatal Data RegistryTM user sites. Quality outcomes exceeded national benchmarks across all geographic regions in both rural and urban settings. A stable and predictable rate of transfer to a higher level of care was demonstrated across geographic regions, with over half of the population remaining appropriate for birth center level of care throughout the perinatal episode of care. Controlling for socio demographic and medical risk factors, outcomes were as favorable for clients in rural areas compared with urban and suburban communities. Conclusions Rural populations cared for within the birth center model of care experienced high‐quality outcomes. Health Policy Implications A major focus of the United States maternity care reform should be the expansion of access to birth center models of care, especially in underserved areas such as rural communities.

show abstract

Association between Hospital Birth Volume and Maternal Morbidity among Low-Risk Pregnancies in Rural, Urban, and Teaching Hospitals in the United States

Cited by 48 publications

References 38 publications

Outcomes among Mothers Who Gave Birth in the Health Facility: Does Birth Preparedness and Complication Readiness Have a Role?

Outcomes among Mothers Who Gave Birth in the Health Facility: Does Birth Preparedness and Complication Readiness Have a Role?

Maternal Opioid Use Disorder and Neonatal Abstinence Syndrome Among Rural US Residents, 2007–2014

Rural resilience: The role of birth centers in the United States

Contact Info

Product

Resources

About