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Fetus

Poster Session 1

(300) Association between fetal anomalies and rurality

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Jordan Rossi, MD

Resident
Loma Linda University Hospital
Jurupa Valley, CA, United States

Coauthor(s)

BP

Bo Park, MPH, PhD

University of California, State Fullerton
Fullerton, CA, United States
Ruofan Yao, MD,MPH

Assistant Professor
Loma Linda University
Loma Linda, CA, United States

Objective: To determine if there is an association between fetal anomalies and rural versus urban areas.

Study Design: Retrospective cohort analysis using data abstracted from the California Office of Statewide Health Planning and Development (OSHPD) Linked Birth File with hospital discharge International Classification of Diseases, 9^th Revision, Clinical Modification (ICD-9-CM) diagnoses between 2007 and 2012. Pregnancies in women were stratified into three community types: metropolitan, small town, and rural. The primary outcome of interest was risk of all fetal anomalies. Secondary outcomes included risk of individual anomalies including abdominal wall defects, anencephaly, neural tube defects, diaphragmatic hernia, heart defects, cleft lip and palate, limb defects, down syndrome, chromosomal defects, and other anomalies. Logistic regression analysis was performed to estimate the odds ratio of the outcome of interest for each community type while adjusting for confounding variables.

Results: There were a total of 1,831,360 pregnancies. Pregnant women living in small town areas had the largest percentage of women with fetal anomalies at 0.48%. Women in metropolitan areas had the lowest percentage of women with fetal anomalies at 0.3%. Pregnancies in small town areas had increased risk of fetal anomalies with OR 1.6 (p-value < 0.001; CI 1.29-1.99). The risk of fetal anomalies in rural areas was OR 1.51 (p-value < 0.001; CI 1.14-2.00). There was a higher risk of down syndrome (OR 3.32 p-value < 0.001; CI 2.07-5.30) and cleft palate (OR 3.39, p-value < 0.001; CI 1.59-7.19) in small town areas. Rural areas had an increased risk of chromosomal anomalies (OR 3.69, p-value =0.001; CI 1.74-7.81). There was no significant association with the other individual anomalies.

Conclusion: There is a higher risk of overall fetal anomalies, including down syndrome and cleft palate, for pregnant women living in small town areas. Rural areas have higher risk of chromosomal anomalies.