title: Birth outcomes across three rural-urban typologies in the Finger Lakes region of New York.
abstract: OBJECTIVE
  The study is a descriptive, population-based analysis of birth outcomes in the New York State Finger Lakes region designed to determine whether perinatal outcomes differed across 3 rural typologies.
  
  
  METHODS
  Hospital birth data for the Finger Lakes region from 2006 to 2007 were used to identify births classified as low birthweight (LBW), small for gestational age (SGA), and preterm delivery (PTD). Maternal residences were defined using 3 existing ZIP code-level rural-urban typologies: Census Bureau ZIP codes, Rural-Urban Commuting Area codes, and Primary Service Areas. Within each typology, rural maternal characteristics and birth outcomes were compared to those in urban areas using multivariable logistic regression models.
  
  
  RESULTS
  In bivariate analyses, rurality was associated with LBW and SGA for all typologies, whereas PTD was associated with residence in the Census Bureau typology only. After controlling for demographic characteristics, births to mothers in the most rural level of the Census Bureau typology and to all rural mothers in the Rural-Urban Commuting Area (RUCA) and Primary Service Area typologies were more likely to be LBW and PTD. SGA was not consistently associated with residence across typologies.
  
  
  CONCLUSIONS
  The typologies produced similar results for these outcomes, although effects were of greater magnitude in the RUCA and Primary Service Area typologies than in the Census Bureau typology. Comparison across typologies can have practical implications for researchers and policy makers interested in understanding the dynamics of rurality and birth outcomes in their regions.
authors.affiliation: Department of Maternal and Child Health and Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina 27516–2524, USA. strutz@email.unc.edu
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Strutz
authors.forename: Ann M
authors.initials: AM
authors.lastname: Dozier
authors.forename: Edwin
authors.initials: E
authors.lastname: van Wijngaarden
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Glantz
mesh_terms: D000293:Adolescent; D000328:Adult; D001719:Birth Certificates; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009518:New York / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology*; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult