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Characterizing Patterns of Maternal Transport Network in a State With Levels of Care and No Formal Perinatal Regions [ID 3521]
Abstract   Peer reviewed

Characterizing Patterns of Maternal Transport Network in a State With Levels of Care and No Formal Perinatal Regions [ID 3521]

Jingyu Li, Lauren Steimle, Margaret Carrel and Stephanie Radke
Obstetrics and gynecology (New York. 1953), Vol.147(5S), pp.39-39S
05/2026
DOI: 10.1097/AOG.0000000000006267.23

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Abstract

INTRODUCTION: Maternal transport plays a critical role in ensuring that pregnant people receive timely, risk-appropriate care. Iowa, unlike some other states, does not have formalized perinatal regions, and it is unclear how interfacility transports are being operationalized in practice. METHODS: We analyzed Iowa birth records from January 1, 2010, to December 31, 2023, which included 2,251 deliveries involving a maternal transport between obstetric facilities across 106 unique routes. We constructed a maternal transport network and applied a community detection algorithm to derive empirical “communities” that represent clusters of obstetric facilities among which transports were most frequently coordinated. RESULTS: Preliminary findings indicated that 2,189 transports (97%) were from lower- to higher-level facilities, and of these, 2,037 (93%) were directed to Level III tertiary care centers. 1,410 cases (63%) of transports were directed to the closest facility offering a higher level of care, suggesting that many transports bypassed nearer options. Three communities that were largely shaped by geographic proximity were identified. However, early analyses further suggest that health system affiliation may also influence choices of transport destination, indicating potential organizational rather than purely geographic drivers of transport decisions. CONCLUSIONS/IMPLICATIONS: Our results reveal that, although Iowa does not have formal perinatal regions, patterns of maternal transport are mostly in line with three de facto regions. These findings may help identify opportunities to enhance care coordination among obstetric facilities, optimize maternal transport, and improve equity in access to high-level maternal care.

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