Adverse Maternal Outcomes Across the Rural-Urban Gradient in the United States

Madelyne Greene , University of Wisconsin–Madison
Ellen Hartenbach, University of Wisconsin-Madison
H Daphne Kuo, University of Wisconsin–Madison
Emily Shrider, University of Wisconsin-Madison
Deborah Ehrenthal, University of Wisconsin–Madison

Rates of maternal mortality and related life-threatening adverse maternal outcomes are rising in the United States. Limitations on the availability of nationally representative data have limited our ability to understand how maternal mortality and adverse maternal outcomes are distributed over the rural-urban gradient across the country. The revised certificate of birth now allows us to evaluate several important adverse outcomes while controlling for individual- and county-level factors across the entire cohort of births to U.S. resident women. In this analysis we examine whether rates of adverse maternal outcomes are higher in rural areas compared to more urban areas, and what factors are associated with increased rates of adverse outcomes. Preliminary findings suggest significant variation in outcomes across the rural-urban gradient and the potential to describe how rurality interacts with other factors to predict life-threatening adverse maternal outcomes.

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 Presented in Session 213. Maternal Morbidity and Mortality in the United States