Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 3

Category: Health Equity/Community Health

Poster Session 3

(772) Geographic and Racial Disparities in Placenta Accreta Spectrum: Does Referral Center Distance Impact Maternal Morbidity?

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Elizabeth Mangone, MD, MPH (she/her/hers)

Obstetrics and Gynecology Resident
University of Arizona College of Medicine Phoenix
Phoenix, Arizona, United States

Coauthor(s)

Kathy Mostajeran, DO, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
University of Arizona College of Medicine
Phoenix, Arizona, United States
LM

Lelan McCann, MD

Obstetrics and Gynecology Faculty Physician
University of Arizona College of Medicine
Phoenix, Arizona, United States
PG

Pamela Garcia-Filion, PhD

Associate Research Professor
University of Arizona College of Medicine
Phoenix, Arizona, United States
CH

Christopher Huls, MD, MSc

Maternal Fetal Medicine Faculty Physician
University of Arizona College of Medicine
Phoenix, Arizona, United States

Objective:
To assess whether distance to Arizona’s sole regional referral center for placenta accreta spectrum (PAS) management is associated with differences in maternal morbidity in a histologically confirmed cohort.

Study Design:
This single-center retrospective study included patients with histologically confirmed PAS who delivered at ≥23 weeks of gestation at the only tertiary referral PAS center of excellence in Arizona between 2012 and 2023. Residential proximity was determined by global positioning system based mapping of distance from centroid of home zip code to centroid of hospital zip code: patients were categorized as local ( ≤50 miles) and remote ( >50 miles). The primary outcome was composite maternal morbidity. A univariate analysis measured the association between maternal demographics [race, payor, body mass index, gestational age, and unscheduled delivery] and clinical outcomes by distance. A multivariate logistic regression measured the likelihood of morbidity by distance by adjusting for demographics and insurance status.

Results:
Of 230 patients with PAS, 49 (21.3%) comprised the remote group. Baseline clinical factors were similar between groups. However, disparities in race and insurance status were observed: remote patients were more likely to identify as Native American (30.6% vs. 5.0%; p < 0.001) and be publicly insured (69.4% vs. 54.7%; p = 0.02).

Remote residence was more likely for patients identifying as a racial minority (OR 2.48, 95% CI 1.28–4.82) and use of public insurance (OR 2.01, 95% CI 1.01–4.00). Despite these differences, composite maternal morbidity did not differ by distance (adjusted OR 1.07; 95% CI 0.53–2.18).

Conclusion:
Patients with PAS living remote from our referral center are disproportionately from marginalized populations. Despite this, once transferred to the state's only PAS center of excellence, maternal outcomes were equivalent, highlighting the resilience of regionalized PAS care models. These findings support expansion of coordinated transfer systems, early referral protocols, and prenatal outreach to optimize equitable PAS access and care.