Urban-rural differences in the pregnancy-related adverse outcome [post]

Vahid Mehrnoush, Amene Ranjbar, Fatemeh Darsareh, Mitra Shekari, Malihe Shirzadfard Jahromi
2022 unpublished
Background Adverse pregnancy outcomes are influenced by a myriad of biological, social, and environmental factors. Little is known about potential urban-rural differences in adverse pregnancy outcomes. The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes. Methods We retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital (a tertiary hospital) in Bandar Abbas,
more » ... n, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups based on living residency: 1) urban group and 2) rural group. Demographic factors, obstetrical factors, maternal comorbidities, and adverse maternal and neonatal outcomes were extracted from the electronic data of each mother. The Chi-square test was used to compare differences between the groups for categorical variables. Logistic regression models were used to assess the association of adverse pregnancy, childbirth, and neonatal outcome with living residency. Results Of 8888 mothers that gave birth during the study period, 2989 (33.6%) lived in rural areas. Adolescent pregnancy was more common in the rural area. Urban mothers had a higher education than rural mothers. Rural mothers were more likely to have a preterm birth, post-term pregnancy, and vaginal birth. Mild to moderate anemia was more common in rural mothers. Multivariate logistic regression showed that rural mothers were at higher risk for preterm birth aOR 1.81 (CI:1.24–2.99), post-term pregnancy aOR 1.5 (CI: 1.07–2.78), anemia aOR 2.02 (CI:1.07–2.34), LBW aOR 1.89 (CI: 1.56–2.11), need for neonatal resuscitation aOR 2.66 (CI: 1.78–3.14), and NICU admission aOR 1.98 (CI:1.34–2.79). On the other hand, the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58 (CI: 0.34–0.99). Conclusions Our study discovered that mothers living in rural areas had a higher risk of developing anemia, preterm birth, post-term pregnancies, LBW, need for neonatal resuscitation, and NICU admission, but a lower risk of cesarean section. More research is required to better understand the reasons for the observed urban-rural differences and to guide a multifaceted response to reduce adverse neonatal outcomes.
doi:10.21203/rs.3.rs-1827244/v1 fatcat:ncmfcn75wraxpeg7qn3kk3udhq