Factors associated with high-risk rural women giving birth in non-NICU hospital settings

Objective:to identify risk factors for childbirth in a facility without neonatal intensive care unit (nicu) capacity among high-risk rural women.study design:using data on all maternal hospitalizations for rural residents in nine states (2010, 2012), we performed logit regression, focusing on women with multiple gestation and preterm birth. we defined a ‘local’ hospital as any maternity hospital within 30 miles (or the nearest hospital).results:rural women with preterm births and multiple gestation pregnancies were less likely to give birth in a hospital with nicu capacity if no local hospital had this capacity. adjusted odds of giving birth in a nicu hospital were lower among women ⩽age 20 (aor 0.87 (95% ci 0.77, 0.98)), medicaid beneficiaries (0.81 (0.75, 0.89)), uninsured women (0.44 (0.32, 0.61)) and black women (0.60 (0.50, 0.71)).conclusions:among high-risk rural pregnant women without local nicu access, younger, low-income, and black women had lower odds of using nicu hospitals.