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Maternity Care Access and Infant Mortality.

Ripley Lucas1, Taylor Thames1,2, Jazmin F Chestnut1

  • 1Perinatal Data Center, March of Dimes, Arlington, Virginia.

JAMA Network Open
|November 11, 2025
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Summary
This summary is machine-generated.

Infant mortality risk is higher in areas with no maternity care access. This increased risk was observed across all infants and specifically among non-Hispanic White infants, highlighting disparities in maternal healthcare access.

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Area of Science:

  • Public Health
  • Maternal and Child Health
  • Health Services Research

Background:

  • Infant mortality is a key indicator of population health.
  • Limited access to maternity care in certain counties may impact infant survival rates.
  • Understanding these associations is crucial for targeted public health interventions.

Purpose of the Study:

  • To assess the link between maternal residence in counties with limited maternity care access and infant mortality.
  • To examine these associations across different maternal race/ethnicity groups and by timing of infant death (neonatal vs. postneonatal).

Main Methods:

  • Cross-sectional study utilizing US birth and infant death records (2017-2021).
  • Maternity care access categorized by county based on facility availability, clinician ratios, and insurance status.
  • Multivariable log-binomial regression used to analyze the association between care access and infant mortality, with stratified analyses.

Main Results:

  • Infant mortality rates increased as maternity care access decreased.
  • Infants in no-access counties had a significantly higher mortality risk (aRR, 1.14) compared to those in full-access counties.
  • This increased risk was significant for non-Hispanic White infants (aRR, 1.20) and observed in both neonatal and postneonatal periods.

Conclusions:

  • Limited maternity care access is associated with increased infant mortality risk.
  • The disparity in risk appears more pronounced among non-Hispanic White infants, suggesting potential unmeasured barriers for other groups.
  • Findings underscore the need to address geographic disparities in maternity care to improve infant health outcomes.