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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Health Equity/Community Health

Poster Session 4

(1126) The Association Between Rural Setting and Adverse Perinatal Outcomes Among Teens

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Rural communities face a variety of challenges that contribute to higher maternal morbidity and mortality compared to pregnancies in urban settings. While research has shown that teens experience worse perinatal outcomes than their adult counterparts, few studies report on teens in rural settings. This study aimed to evaluate rural adolescents’ perinatal outcomes as compared to urban adolescents as well as compared to rural adults.

Study Design:
This is a retrospective cohort study of California’s linked vital statistics and hospital discharge data (2008-2020). We included 13-50 years old with singleton, non-anomalous births delivered between 23-42 weeks. Patients were stratified by rural or urban setting, which was determined using patient’s residential zip code. We further categorized patients into adolescents or teens (13-18 years old) and adults (19-50 years old). Two separate analyses were performed. First, we compared rural adolescents with urban adolescents and then we compared rural adolescents with rural adults. Chi-square tests and Multivariable Poisson regression analyses were used to determine risk of maternal and neonatal outcomes among rural adolescents.

Results:

We included 402,608 births, of which 44% (n= 177,015) were adolescents (6.9% rural adolescents and 93.1% urban adolescents). When compared to urban adolescents, rural adolescent pregnancies had significantly increased risk of postpartum hemorrhage (aRR=1.24, 95% CI: 1.13-1.36).  Rural adolescents had lower risk of preterm delivery < 37 weeks when compared to urban adolescents (aRR= 0.89, 95% CI: 0.81-0.99), and rural adults (aRR=0.86, 95% CI: 0.75-0.98). Neonates born to rural adolescents had significantly higher risk of infant death when compared to urban adolescents (1.51, 95% CI: 1.13-2.02) and rural adults (aRR=1.43, 95% CI: 1.04-1.95).

Conclusion:

Clinicians and public health officials should be aware that both location and age may influence perinatal outcomes. Further research to elucidate how rural settings and age influence perinatal complications will be important in identifying effective interventions.