Birth Outcomes Related to Distance in Rural and Frontier Kansas.

Kansas Journal of Medicine Pub Date : 2022-09-21 eCollection Date: 2022-01-01 DOI:10.17161/kjm.vol15.17118
Janet A Montelongo, Joel Hake, Bruce S Liese, Michael Kennedy
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Abstract

Introduction: Women from rural communities must travel greater distances to secure obstetrical care. This study sought the extent to which distance traveled by mothers for obstetrical services affects birth outcomes in rural and frontier counties of Kansas.

Methods: Medical students invited women over the age of 18 to participate in a recall survey regarding their children under three years old. Participants were a sample of convenience, and the length of data collection was a month. A bivariate analysis was performed on the responses gathered regarding obstetrical measures as a function of self-reported distance traveled to the hospital of delivery.

Results: Eighty-five women completed the survey, but only 76 satisfied all eligibility requirements. No statistical difference in birth outcomes were found between women who travel more than or less than 20 miles. However, when correlating data to that of the Kansas Hospital Association and the Kansas Department of Health and Environment, counties without birth facilities had a higher percentage of very low birth weights (< 1,500 grams) and more babies born at full-term when compared to counties that offer birth facilities. Babies born to mothers who reside in counties with obstetrical services were born at an earlier gestational age than those without birth facilities. Lastly, babies born into a family with income less than $50,000 weighed less and had a shorter gestational age than those from a more affluent household.

Conclusions: The results revealed counterintuitive findings that deserve to be explored further by a study with greater statistical power.

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堪萨斯州农村和边境地区与距离相关的出生结果
导言:来自农村社区的妇女必须长途跋涉才能获得产科护理。本研究旨在探讨堪萨斯州农村和边境县产妇接受产科服务的路程对分娩结果的影响程度。方法:医学生邀请18岁以上的女性参与一项关于其3岁以下子女的回忆调查。参与者为方便样本,数据收集时间为一个月。对收集到的关于产科措施的响应进行双变量分析,作为自我报告的到分娩医院旅行距离的函数。结果:85名女性完成了调查,但只有76名符合所有资格要求。出行超过或少于20英里的女性在生育结果上没有统计学差异。然而,当将数据与堪萨斯州医院协会和堪萨斯州卫生与环境部的数据相关联时,与提供分娩设施的县相比,没有分娩设施的县出生体重非常低(< 1500克)的比例更高,足月出生的婴儿更多。居住在有产科服务的县的母亲所生的婴儿比没有分娩设施的母亲所生的婴儿的胎龄更早。最后,收入低于5万美元家庭出生的婴儿比富裕家庭出生的婴儿体重更轻,胎龄更短。结论:结果揭示了违反直觉的发现,值得通过更大的统计能力的研究进一步探索。
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