CORE Posters Fall 2025

The Impact of Travel Time to Care and Related Pregnancy Factors on Birthing and Postpartum Complications in Low-income Mothers in Southwest Virginia M. Al Mir, F. Ambrin, A. Collura, M. Oruganti, S. Pham, P. Sau, C. Weaver, J. Nicholson, B. Kadio Edward Via College of Osteopathic Medicine, Blacksburg, VA Abstract Results Abstract

(GROUP W)

Ms i gant ei frinc aa nl ht er iaslkt hs ctaorme da et esrenr at sl —a nrde gi ni of anns tl ahcekailnt hg , apcacretsi csui bl al er lpyriennraut ar al ,l dceolmi v me ruy,nai tni de sp. oI ns tAppa rritlu2m0 2s e4r, v i c e s — p o s e Md eol invtegroymuenri yt . CTohui sn st yt ,uVd iyr geixnai ma bi neecsa mt hee ar eml aat ti eo rnns ahli pc abree t dweeseenr ti nf oc lrl eoaws iendg ttrhaev ecll odsi sutraenoc fe i tt os omnal yt elranbi ot yr ca anrde a n d mp raotveirdnearl -ai vnaf ai lna tb hi l ei tayl, tahnoduct oc ommmeus ,nwi cha itlieo na l gs ao pass. sWe ses icnogn sdyusctteemd igc eboasrprai et irasl ianncal ul ydsiensg ut sr ianngs pd oe r- itda et inotni f, i ceods t , eC leenc tter ro n( Fi cQmH eCd) iicna Ml roe nc ot gr od ms (eEr My CR os )u nf rtoym. Qpuaatni et int at st i rveecme i ev ti nh go dms amt eeransaul rceadr et raatv ae lFdeids et ar na lcl ey sQt uo aml i fai teedr nHi et ya l t h fNaIcCi lUi t iaeds ma ni sds iaosnsse, sasne dd pc or er vr ee lnattiivoen cs awr ei t uh t ai ldi zvaetri soen .oAu ttcoot ma l eosf, 3i n4c pl uadt ii enng t ps rwe teerrema nbai rl yt hz e, md : a5t 3e r%n aol f mmoortbhi edri st y , tt rr aa vv ee ll ee dd mm oo rr ee tt hh aa nn 31 0h omui rn. ,Pwr ei tnhaat anl avvi seirtadgoecoufm4e5n. 5t amt iionnu wt eas s, tion caoc cnessi sst me natt ae cr rnoi tsys craerceo.r1d8s %. N oo fspt aattiisetni ct sa l l y sc iogrnr ief li ac taino tnaws saoscfioa ut inodn b( pe t>w0e .e0n5 t)rwa vaesl ot ibms ee ravne dd bb ierttwh ienegn ctor ma vpelli ct iamt i eo na sn. dWi nhfeann tc ob mi r tpha rweedi gt oh ts. tNa toe swi gi dnei f idcaatnat sf ihnodwi ni gnsg ht hi gaht l wi g oh mt seunb isnt aVni trigailnl yi al ot rnagveerl tarna vaevletri amgeesoffo 1r 7w. 6o mm ei nnui tne sMtoonrtegaocmh et rhye Cnoeua nr et ys tamn da the irgnhi lt iyg hc at r e , t h e it mh ep nr oe ve ed mf oar tme rint iagla- ct ihoi nl dsht reaatlet hg i (eMs . CI nHt)e or vuet nc ot imo ne ss . sFuucthu ar es raeMs eoabricl he Cwai rl leeUx pn li ot rme aGyI Sh-ebl pa sreedd ua cc ceebs as ri br ii el i rt ys a n d mruoradlemlsattoeirnnfaolrcmarheedaeltshecratrse. resource allocation, mobile clinic routing, and strategic facility placement in 1. Study design Ta chci es ssst ut od ym ae tme rpnl oa yl ec da rae qhua as l oi t na tbi vi ret ha ni nagl yasni sd t po oasstspeasrst ut hme or ou ltec ot hmaet ss. oPcai or tei cc oi pnaonmt si cwset raet ui ds eanntdi f i e d tahdrmouingihstararteitornosoprepcrtoivveidreervsieawt tohfeeCleHcCtrNonRiVc. health records and identified through healthcare 2. Study population TV ahlel esyt ubdeyt wf eo ec nu sAepdroi ln1p, 2a t0i 2e n4 t, sa nr edc Jeui vnien g1 ,c2a0r e2 5a t. Tt hhee Ct aormg emt upnoipt yu lHa teiaolnt hi nCcel nu tdeerdopf rt ehgenNa enwt aRnidv e r pc roi st et -rpi aa rf ot ur mt hme sottuhde yr sproepcue li av ti ni ogncianrcel uadt et hi ne dCiHv iCd uNaRl Vs wd ui trhi nmg i tshs ii sn gt i md aet af roanmkee. yO vu ar rei xa cbllue ss i oa nn d pr eamt i eonv tesd wf rhoomd ai dn yn odta rt ae cceoi lvl ee cctoi onns i tsot eansts cuar reepaatr Ct iHc iCp aNnRt Vc. oAndf iddi et inotni aa ll il tyy, paenrds odna at al iids esnetci uf ireerlsy w e r e stored on an institutional drive that is only accessible to researchers. 3.Study variables Exposure variables: • Distance traveled to receive care (measured in miles), • Time of travel to care • Income level Outcome variables: • Bd yi rsttho ccioam, epxlci ce as tsiiov ne b- luenepdlianngn/ ehde mc eosrarrhi aa ng es, egcet si ot ant, i uo nn ap ll adni anbe edt eNsI Co Ur pardeme ci sl as mi o pn s, isah. o u l d e r • tPhorsotmpabrotuemmbcoolmispmli,coartihoynpse-rpteonsstipoanr.tum depression, low birth weight babies, infection, 4. Data Collection Eo uHtRc os mf r eo sm, aCnHdCpNo sRtVp awr et ur emr ce ov mi e wp lei cda at inodn sd. aTt ha iws da sa tcao cl loe lcl teecdt i oo nn imn ca ltue dr ne ad l pcaatriee na tc caedsdsr, ebsi sr ,t h lcoocma tpi ol i nc aot if omn as taenr dn arlecpaorret,eddoicnucmo me net eodr sboi rcti ho eccoomn po ml i ciactsi ot antsu, sd. o c u m e n t e d p o s t p a r t u m 5.Data analysis Tb yh ec adl ac tual actoi nl l ge ct theed mweaasna dn iasltyaznecde ut rs ai nv ge lqe ud aannt di t at itmi v ee tmo ectahroed, swthhi al et as ul smo mr eaproi zr et i nh ge at lht eh cparreev aa cl ecne cs es o1f0m.06at.0erfnoarlmanadcObSirwthascoumsepdlifcoartiaolnl sstfartoismticthael adnaatlaysreisp. orted in the EHRs. GraphPad Prism Introduction or Methods

References • Nfaocislittaietisstaincadlliynfsaingnt ibfiicrathntwaesisgohcti.ation was found between the distance to maternity care • Ncoomsptalitcisattiicoanlsly significant correlation was found between distance and birthing • Ihno sVpi ri tgai nl . iIan, wMoomn tegno mt r ae vr ye l Caonuanvt ey,r a5 g0e%o of 1f m1 . 2o tmh ei lress t ar anvde1l e7d. 63m1 –i n6 u0 tme si nt ou ttehse wn he ai lree 1s t8 b%i rot hf i n g mothers traveled >1 hour Oouutrcfoimndeisn.gHsodwoenvoetr,support the hypothesis that geographic barriers impact maternal-infant we have established Montogomery County as a maternity care desert. Limitations include small sample size and inconsistent prenatal records, which may have rl oendgu-ctee dr mo uoruat cboi lmi t ye st,oadnedt ea cptpol yt hceornat isns uo oc iuast idoantsa. Fa nu at ul yrsei sr ersaet ah recrht hs ha no ucladt eugsoe rliacragl edract ao haoprpt rso, tarcahc, k while also exploring GIS accessibility model to guide resource allocation. • Gleeson DE. Maternity care deserts: Maternal and child health associations. [Order No.31242580]. Yale University; 2024. • Kolb, K. (2024, September 18). Southwest Virginia Moms face big challenges with maternity care . Cardinal News. https://cardinalnews.org/2024/09/18/southwest-virginia-moms-face-big-challenges-with-maternity-care/ • Roa L, Uribe-Leitz T, Fallah PN, et al. Travel time to access obstetric and neonatal care in the United States. Obstet Gynecol. 2020;136(3):610-612. doi:10.1097/AOG.0000000000004053. • March of Dimes. Virginia Report Card. March of Dimes. Accessed [3/27/24]. Available from: https://www.marchofdimes.org/peristats/reports/virginia/report-card • M ou i t n c i o o mn e S s C . , Krans EE, Brooks MM, Mendez DD, Haggerty CL. Association of driving distance to maternity hospitals and maternal and perinatal Obstetrics & Gynecology . 2022;140(5):812-819. doi:10.1097/aog.0000000000004960 • FacornotsesntohteJ,UBnriitgeadncSetaCte, Ls.ucas R, Stoneburner A. Navigating geographical disparities: Access to obstetric hospitals in Maternity Care Deserts and BMC Pregnancy and Childbirth . 2024;24(1). doi:10.1186/s12884-024-06535-7 • Gwroamnde-nGwuiiltlhausmoceia-Pl edrisreandvoaundtJaAg,eO: ArigthliaeoPr,yC-igguniadcecdosEy.sBteamrraietircsraenvdiefwac. ilitators of maternal healthcare utilisation in the perinatal period among Midwifery . 2022;105. doi:10.1016/j.midw.2021.103237 • Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38(8):1091-1110. doi:10.1016/0277-9536(94)90226-7 • World Health Organization. (n.d.). Pregnancy, childbirth or the puerperium (Entity ID: 1876974203). In International classification of diseases, 11th revision (ICD-11) . World Health Organization. https://id.who.int/icd/entity/1876974203 • JDaaznmi ei nl l eFoPnr ot ecnoopti ,oM, MP PHH; R; Ki pellel yy EL ur nc sats,, MMPPHH;, TAisahslheay LSet ot onsetbauk r, nPehrD, M, MPPHH; ;CKhar itshtri ny na BMriisghaknicne, ,DMr PP HH,; ME rPi nH ,J oMnAe;s E, JlDi z;aKbeeltlhy CHhu.b(bna. dr d. ) ,. M P H ; M o t o k o O i n u m a ; Maternity Care Report virginia . WHERE YOU LIVE MATTERS: MATERNITY CARE IN VIRGINIA. https://www.marchofdimes.org/peristats/assets/s3/reports/mcd/Maternity-Care-Report-Virginia.pdf Wd eev ewl oo pu ml d el ni kteatnodt dh aa tnak ctohlel eCc ot imo nm. Wu nei twy oHuel adl tahl sCoelni kt ee rt oo ft ht haen kN De wr. RRai vme ur VAanl al enydfaokrrti hs he ni raans fsoi sr t ha ni sc e i n aNsiscihsotalsnocne fionrsatallttishteiciragl udiadtaanacneaalynsdisa. sFsiinsatallny,cwe.e would like to thank Dr. Bernard Kadio and Ms. Jess Acknowledgements Figure 7. Pie Chart of travel time to maternal care facility. 50% of Mothers receiving care at the Community Health Center of the New River Valley tt rraavveelleddi sbteatnwceeeton t3h1e-6n0eamrei nstubtei rstthoi nrgecheoivsepimt aal tienrnVai rlgbi ni ritahoi nf g11ca. 2remwi lietsh oarn1a7v.e6rmagienuotf e4s5(.F5omteinnoutteest.. ATlhi s i s i n cont rast wi t h t he reported average 10 ). In a maternity care desert, the average tt rhaavne 4l d0 i smt ai lne cs et oi s a3b0i. r6t hmi ni l ge sc, esnutgegr,erset si ni dg eosui rn sat umdayt ep ronpi ut yl act ai or ne , dwe hs eerrte, 4f u5 r. 5t h%e ro df me mo ot hnesrt sr at trianvge tl ehde 2i n1c-r4e0a smi ni lge sl aacnk do 2f 4a c. 2c %e s so ft omMo tohnet rosg torma veerlye dC ogur enat yt e r (Fotenot et. al 10 ). Conclusions

Figure 2. Pie Chart of total months' gestation completed at time of birth. 48.5% of patients were born at 39-40 weeks' gestation.

Figure 1. Pie Chart of Mother's Age at Time of Birth. 42.4% of women included in this study were between 25-34 years old.

Figure 3. Representation of birthing centers local to Montgomery County, VA. 1). Lewis GWaylethSeavliellme,C2o)m. Cmaruinliiotny HNoeswpiRtaivler Valley Medical Center 3). Carilion Roanoke Memorial 4). Figure 4. Representative heat map of patient residence based on zip code. The greatest number of patients seen are located in Christiansburg, VA.

Figure 5. Stacked Bar Chart of BMi ar tt eh rWn iet yi gCh at rves FDaicsitlai tnyc. eH tBoWN=e ahri eg sht bNiBr tWh =wneoirgmh ta(l >b4i r0t0h0wg )e;i g h t ( 2 5 0 0 - 3(<929590g0);gL)BW= low birth weight

Figure 6. Stacked Bar Chart of Bt oi rNt he ianrge sCt oMmapt lei rc na ti ti oy nCsa rves FDaicsitl ai tnyc. e CMoamj opr,l iMc ai nt i oorn, so rwNe roen cel, aasss ipf ieerdWa sH O ICD-11 Classifications.