Bibiana Avella Molano, MD, links rural residence to birth complication risk

Rural residence continues to be a significant factor influencing maternal and neonatal health outcomes, according to new research presented by Bibiana Avella Molano, MD, anesthesiology resident at the Medical College of Georgia. In this discussion with Contemporary OB/GYN, Avella Molano explains that infants born to mothers living in rural areas are more likely to have non-reassuring Apgar scores, a key indicator of newborn health immediately after delivery.

The study also found that rural residents are at higher risk of inadequate prenatal care, underscoring systemic disparities in access to maternal health services. Using multivariate logistic regression, the analysis identified rural residence, alongside factors such as race, insurance type, and comorbidities, as significant predictors of adverse birth outcomes.

Contemporary OB/GYN:

What is the link between rural residence and birth complication risk?

Bibiana Avella Molano, MD:

So, basically, we did a couple of analyses. On one side, we basically tried to see if rural residents were more prone to have lower or non-reassuring Apgar scores, and this was statistically significant. And the other thing that was significant among residents in rural areas is that these patients are more prone to have lack of prenatal care. On the other side, we basically did a multivariate logistic regression trying to assess which factors, like pregnancy-related factors, were related with non-reassuring Apgar scores. In there, we included like the race, the type of insurance, comorbidities, and all that. And among those things, I mean, clearly living in a rural area was a risk factor for non-reassuring Apgar score. Also, gestational age, like the higher the gestational age, of course, these patients had, they were more likely to have reassuring Apgar scores.

Contemporary OB/GYN:

How might these outcomes impact long-term patient health and health disparities?

Avella Molano:

I mean, clearly these patients residing in rural areas are more prone to these non-reassuring Apgar scores. That means that their babies are more likely to like require farther treatment in the hospital and even higher mortality risk. So, basically, that just gives insights of where do we have to target future interventions, trying to do like community outreach programs to see what are the barriers that these patients are facing to have access to prenatal care.

Contemporary OB/GYN:

What steps can clinicians take to support patients from rural areas?

Avella Molano:

I think, so now that we know which are the factors that are associated with non-reassuring Apgar scores and all that, that just let us as clinicians to know which patients we should be aware of earlier. Because as you know, well, you might not know, but like in the hospital, usually the obstetric team is the one that has the first contact with the patient, and sometimes there are some delays.So, if we are aware of those things that have made them at risk for non-reassuring Apgar scores, that just tells them that we need to be involved earlier. That way we can just optimize maternal morbidities and also that enables us to be ready in case of a non-emergent delivery.

No relevant disclosures.

Reference

Mother's ZIP code, lack of access to prenatal care can negatively impact baby's health at birth, new studies show. American Society of Anesthesiologists. October 11, 2025. Accessed October 16, 2025. https://www.asahq.org/about-asa/newsroom/news-releases/2025/10/mothers-zip-code-and-lack-of-access-to-prenatal-care-can-negatively-impact-baby-health-at-birth.