Urban-rural differences in the pregnancy-related adverse outcome

Background

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 a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups based on living residency: 1) urban groupand 2) rural group.Demographic factors, obstetrical factors, maternal comorbidities, and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother. The Chi-square testwas 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 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), low birth weight (LBW) aOR 1.89 (CI: 1.56-2.11), need for neonatal resuscitation aOR 2.66 (CI: 1.78-3.14), and neonatal intensive care unit (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.