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.