ArticlePublic health2025
Severe maternal morbidity in Louisiana by race, rurality, poverty, and availability of care.
Article in Public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Development and Application of an Algorithm to Identify the Primary Underlying Condition for Cases of Severe Maternal Morbidity.Obstetrics and gynecology · 2026Article
- Remote Patient Monitoring in Louisiana Medicare Beneficiaries With Diabetes or Hypertension: Retrospective Cohort Study of 2016-2020 Claims Data.Journal of medical Internet research · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
objectivesRace-ethnicity and place-based variables such as rurality, ZIP code-level poverty, and county maternity care desert status have been associated with severe maternal morbidity and maternal mortality rates in the US. We examined these associations in Louisiana, which has one of the highest maternal mortality rates in the US. STUDY
designThis was a birth cohort study.
methodsWe used state-wide inpatient birth hospitalization discharge data in Louisiana between 2016 and 2021. Mixed-effects logistic regression models with individuals nested within ZIP codes were used to estimate adjusted odds ratios (aOR) for non-transfusion severe maternal morbidity (nt-SMM, defined using the CDC index) according to race-ethnicity and place-based variables (overall and stratified by race-ethnicity).
resultsAmong 326,597 birth hospitalizations, 2486 (0.77 %) involved nt-SMM. Non-Hispanic Black and Hispanic individuals had increased risk of nt-SMM compared to Non-Hispanic White individuals, after adjustment for sociodemographic factors, a comorbidity index, and place-placed variables (aORs 1.36, 95 %CI 1.23-1.51 and 1.39, 95 %CI 1.21-1.59, respectively). Residence in a maternity care desert county or rural ZIP code did not increase risk; however, residence in a ZIP code in the highest quartile of poverty was associated with increased risk (aOR 1.26, 95 %CI 1.04-1.51). When stratified by race and ethnicity, an increased risk remained for Non-Hispanic Black and Hispanic individuals residing in the highest-poverty ZIP codes (aORs 1.33, 95 % CI 1.00-1.78 and 1.32, 95 % CI 1.05-1.65, respectively), and a potential increased risk associated with living in a maternity care desert emerged for Black individuals (aOR 1.33, 95 % CI 1.00-1.76), but confidence intervals included 1.00.
conclusionsIn Louisiana, to reduce the rate of nt-SMM, social factors must be addressed, especially for non-Hispanic Black individuals living in areas with the highest levels of poverty and in maternity care deserts, as they had the highest risks in this population.
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