Assessing Health and Wellness Outcomes of Medicaid-Enrolled Infants Born to Adolescent Mothers
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Assessing Health and Wellness Outcomes of Medicaid‑Enrolled Infants Born to Adolescent Mothers Toyya A. Pujol1 · Anna Smith2 · Nicoleta Serban2 · Melissa Kottke3 · Julie Swann4 Accepted: 7 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Adolescent pregnancy · Adolescent birth · Infant mortality · Wellness visits · Emergency department visits
Significance Toyya A. Pujol and Julie Swann completed work while affliated with Georgia Institute of Technology. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-03086-z) contains supplementary material, which is available to authorized users. * Toyya A. Pujol [email protected] 1
School of Industrial Engineering, Purdue University, 315 N Grant St., West Lafayette, IN 47906, USA
2
School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Dr. NW, Atlanta, GA 30332, USA
3
Department of Gynecology and Obstetrics, Emory University, Jane Fonda Center, 46 Armstrong Street, Atlanta, GA 30303, USA
4
Department of Industrial and Systems Engineering, North Carolina State University University, 400 Daniels Hall, Raleigh, NC 27695, USA
What’s Known on This Subject: Adolescent birth has been linked to negative socioeconomic and health outcomes. The U.S. has the highest rate of t
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