Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study
Objective: Assess whether maternal rural residence was an independent risk factor (RF) for spontaneous preterm birth (sPTB) at a Midwest tertiary care center. Methods: After excluding deliveries complicated by indications for induced preterm birth, there were 16 974 deliveries among 13 339 women bet...
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| Language: | English |
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SAGE Publishing
2025-07-01
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| Series: | Journal of Primary Care & Community Health |
| Online Access: | https://doi.org/10.1177/21501319251357688 |
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| author | Abbie Lund Barcey T. Levy Yinghui Xu David A. Bedell Mark K. Santillan |
| author_facet | Abbie Lund Barcey T. Levy Yinghui Xu David A. Bedell Mark K. Santillan |
| author_sort | Abbie Lund |
| collection | DOAJ |
| description | Objective: Assess whether maternal rural residence was an independent risk factor (RF) for spontaneous preterm birth (sPTB) at a Midwest tertiary care center. Methods: 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. Results: 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. Conclusion: Rural residence, extremes of maternal age, maternal smoking, female newborn sex, and transfer from an outside hospital were significant and independent RFs for sPTB. |
| format | Article |
| id | doaj-art-20d79e0dfa1948218c5e0f2dc6e2b018 |
| institution | DOAJ |
| issn | 2150-1327 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SAGE Publishing |
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| series | Journal of Primary Care & Community Health |
| spelling | doaj-art-20d79e0dfa1948218c5e0f2dc6e2b0182025-08-20T02:46:21ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-07-011610.1177/21501319251357688Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional StudyAbbie Lund0Barcey T. Levy1Yinghui Xu2David A. Bedell3Mark K. Santillan4The University of Iowa Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USADepartment of Family and Community Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Family and Community Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Obstetrics and Gynecology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USAObjective: Assess whether maternal rural residence was an independent risk factor (RF) for spontaneous preterm birth (sPTB) at a Midwest tertiary care center. Methods: 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. Results: 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. Conclusion: Rural residence, extremes of maternal age, maternal smoking, female newborn sex, and transfer from an outside hospital were significant and independent RFs for sPTB.https://doi.org/10.1177/21501319251357688 |
| spellingShingle | Abbie Lund Barcey T. Levy Yinghui Xu David A. Bedell Mark K. Santillan Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study Journal of Primary Care & Community Health |
| title | Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study |
| title_full | Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study |
| title_fullStr | Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study |
| title_full_unstemmed | Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study |
| title_short | Is Rural Residence an Independent Risk Factor for Spontaneous Preterm Birth at a Midwestern Tertiary Care Center? A Cross-Sectional Study |
| title_sort | is rural residence an independent risk factor for spontaneous preterm birth at a midwestern tertiary care center a cross sectional study |
| url | https://doi.org/10.1177/21501319251357688 |
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