Toyya A Pujol1, Julie Swann2, Anna Smith3, Nicoleta Serban3, Melissa Kottke4. 1. School of Industrial Engineering, Purdue University, 315 N Grant St., West Lafayette, IN, 47906, USA. tpujol@purdue.edu. 2. Department of Industrial and Systems Engineering, North Carolina State University University, 400 Daniels Hall, Raleigh, NC, 27695, USA. 3. School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Dr. NW, Atlanta, GA, 30332, USA. 4. Department of Gynecology and Obstetrics, Emory University, Jane Fonda Center, 46 Armstrong Street, Atlanta, GA, 30303, USA.
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.
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.
Authors: Andrea K Morrison; Matthew P Myrvik; David C Brousseau; Raymond G Hoffmann; Rachel M Stanley Journal: Acad Pediatr Date: 2013-03-05 Impact factor: 3.107