Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study

Abbie Lund; Barcey T Levy; Yinghui Xu; David A Bedell; Mark K Santillan

doi:10.1177/21501319251357688

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Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study

Journal article

Open access

Peer reviewed

Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study

Abbie Lund, Barcey T Levy, Yinghui Xu, David A Bedell and Mark K Santillan

Journal of primary care & community health, Vol.16, pp.1-12

01/2025

DOI: 10.1177/21501319251357688

PMCID: PMC12314244

PMID: 40727985

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Abstract

Assess whether maternal rural residence was an independent risk factor (RF) for spontaneous preterm birth (sPTB) at a Midwest tertiary care center. After excluding deliveries complicated by indications for induced preterm birth, there were 16 974 deliveries among 13 339 women between May 1, 2009, and May 31, 2023. Standard descriptive statistics and Generalized Linear Mixed Models were used to identify RFs for sPTB. Of the 16 974 deliveries, 89.1% were full term, 28.8% were of rural mothers, and the mean maternal age was 29.6 years (y). 15.5% of rural deliveries were sPTBs versus only 9.1% of urban deliveries (P<.001). Significant independent RFs for sPTB included the extremes of maternal age (aOR, 2.14 for age 14 to <20 y and aOR, 3.37 for age ≥40 y) compared to age 20-<30 y, rural vs. urban residence (aOR, 1.56), maternal smoking (aOR, 2.47), transfer from an outside hospital (aOR, 671.3), and female sex of the baby (aOR, 0.79). With the transferred deliveries excluded these factors remained significant with similar aORs and Asian race was an additional significant protective factor (aOR, 0.57). Body mass index, race, ethnicity, type of medical insurance, and primigravidity were not significant RFs. Rural residence, extremes of maternal age, maternal smoking, female newborn sex, and transfer from an outside hospital were significant and independent RFs for sPTB.

Pregnancy

Adolescent

Adult

Cross-Sectional Studies

Female

Humans

Infant, Newborn

Maternal Age

Midwestern United States - epidemiology

Premature Birth - epidemiology

Risk Factors

Rural Population - statistics & numerical data

Tertiary Care Centers - statistics & numerical data

Urban Population - statistics & numerical data

Young Adult

Details

Title: Subtitle: Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study
Creators: Abbie Lund - University of Iowa
Barcey T Levy - University of Iowa
Yinghui Xu - University of Iowa
David A Bedell - University of Iowa
Mark K Santillan - University of Iowa
Resource Type: Journal article
Publication Details: Journal of primary care & community health, Vol.16, pp.1-12
DOI: 10.1177/21501319251357688
PMID: 40727985
PMCID: PMC12314244
NLM abbreviation: J Prim Care Community Health
ISSN: 2150-1319
eISSN: 2150-1327
Language: English
Date published: 01/2025
Academic Unit: Epidemiology; Family and Community Medicine; Obstetrics and Gynecology
Record Identifier: 9984927085802771

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