Study: Mom’s insurance, mental illness impact baby’s first year


Jen Rini , The News Journal, October 27, 2016 – Babies born to women covered by Medicaid and with diagnosed mental illnesses are more likely to end up back in the hospital, a local study found.

Researchers from Christiana Care Health System, Delaware Medicaid and HealthCore, a research group within insurance company Anthem, Inc., matched insurance claims and hospital data to identify factors associated with hospitalizations among newborn Medicaid recipients.

The study, published in Hospital Pediatrics, evaluated 4,112 infants delivered at Christiana Hospital whose parents were covered by Medicaid. Babies were born between Jan. 1, 2009, and Dec. 31, 2012.

What researchers found was an association between maternal mental illness and medical care for their babies, explained lead researcher Dr. David Paul, chair of pediatrics at Christiana Care.

Historically, research showed that less than 10 percent of infants are either hospitalized or need emergency care during their first year of life. But the results of this study found that in the first six months post-delivery, 41 percent of the newborns were treated in the emergency department and 11 percent were rehospitalized for overnight stays.

The children could have been admitted in hospitals in Delaware or around the country, but parents were still considered Delaware Medicaid recipients.

Of those infants treated in the ED, 34 percent were born to moms diagnosed with a mental illness and 16 percent were born to moms with depression. About 40 percent of infants who were hospitalized were born to women with a diagnosed mental illness other than bipolar disorder or depression, such as schizophrenia.

Researchers wrote that infants who were rehospitalized were more likely to be diagnosed with respiratory illnesses, jaundice, sepsis and receive mechanical ventilation. Babies were also likely to be of lower birth weight and born to African-American parents.

The moms that were included in the study had to have Medicaid insurance for at least nine months before delivering their babies and were evaluated for about a year after.

The study extrapolated how often moms saw a doctor and could identify what medications they were using. However, Paul said more research needs to look into why certain factors influence readmission rates for infants.

“There are many, many factors on the maternal side rather than the infant side that drove readmission,” Paul said. “Those patterns that we see in the mother before birth are then apparent to the baby after birth.”

He said the study does show that there should be increased access to mental health care to pregnant women and there could be more emphasis on educating moms on handwashing and vaccination to decrease respiratory hospitalizations.