Assessing Health and Wellness Outcomes of Medicaid-Enrolled Infants Born to Adolescent Mothers

• Authors: Toyya A Pujol, Purdue University; Anna Smith, Georgia Institute of Technology; Nicoleta Serban, Georgia Institute of Technology; Melissa Kottke, Emory University; Julie Swann, North Carolina State University
• Journal Title: MATERNAL AND CHILD HEALTH JOURNAL
• Volume: Volume 25, Number 5
• Publisher: SPRINGER/PLENUM PUBLISHERS | 2020-11-20, Pages 821-831
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s10995-020-03086-z
• Subjects: Health Sciences, Obstetrics and Gynecology; Engineering, Industrial
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Adolescent pregnancy; Adolescent birth; Infant mortality; Wellness visits; Emergency department visits; LOW-BIRTH-WEIGHT; UNITED-STATES; PREGNANCY; EMERGENCY; MORTALITY; RATES

Abstract

Objective: To assess the effect of adolescent birth on the health and wellness of these infants within their first year of life. Methods: Our study focused on 2011 Medicaid births nationwide. The study group (infants born to adolescents, aged 10 to 19 at time of birth) was matched with infants born to adults (aged 20 to 44 at time of birth), based on demographics. Statistical tests (proportion test and Poisson test) were used to compare the outcomes of these two groups to determine if differences were significant. Results: The outcomes assessed were: low birth weight (LBW), substance exposure, foster care, health status, infant mortality, emergency department (ED) visits, and wellness visits. Of the 68,562 infant pairs included in the study, we found statistically significant higher rates of LBW (P ≤ 0·005), infant mortality (P = 0·05), and ED visits (P ≤ 0·005) for infants born to adolescents at the 95% confidence interval. The rate of wellness visits for all infants was well below the recommended amount. Additional differences were found at the race/ethnicity and urbanicity levels. Conclusion for Practice: Infants born to adolescents had a higher rate of ED visits within the first year of life, however, the increased rates of LBW and mortality for the Medicaid population are not as significant as previous national studies suggest. Analysis of outcomes across stratification helped identify vulnerable populations (i.e. urban infants). Public health programs are urged to examine ED visits in infants born to adolescents among the Medicaid population. Improved health education or phone-based resources could help reduce unnecessary visits and reduce cost.