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Comparison of birth outcomes of mothers covered by Medicaid versus those privately insured when accounting for social determinants of health

Abstract

Objectives

To determine the association between maternal health insurance type and birth outcomes [prematurity, small for gestational age (SGA), Term/Appropriate for gestational age NICU admission (Term/AGA-NICU) & composite birth outcomes (CBO)] accounting for social determinants of health.

Design/Methods

A cross-sectional study of maternal surveys and birth certificate data of singleton live births in NY born to mothers with Medicaid (M) or Private Insurance (PI).

Results

1015 mothers [M = 631, PI = 384) included. Individual birth outcomes did not differ between groups. Adjusting for social, demographic and clinical covariates, M mothers had similar odds of preterm birth, SGA, Term/AGA-NICU admission and CBO compared to PI.

Conclusions

M mothers were as likely as PI mothers to deliver a preterm, SGA or a Term/AGA-NICU infant after controlling for social determinants of health. Despite more social adversity among enrollees, our study suggests NY Medicaid recipients have similar birth outcomes to privately insured, socially advantaged women.

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Fig. 1: Flowchart of subjects approached, consented and included in the final analysis.

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Acknowledgements

We thank the medical students and research staff who helped us with the study methods.

Author information

Authors and Affiliations

  1. Division of Newborn Medicine, Maria Fareri Children’s Hospital at Westchester Medical Center, Valhalla, NY, USA

    Kriti Damodaran, Heather L. Brumberg, Clare Giblin & Shetal Shah

  2. Division of Neonatology, UHS, Binghamton General Hospital, Binghamton, NY, USA

    Nilima Jawale

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  1. Kriti Damodaran
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KD drafted the manuscript and performed the initial analysis. HLB assisted with analysis, reviewed drafts of manuscripts and made substantial contributions to draft. NJ performed preliminary analysis for the project.CG assisted with Institutional Review Board Applications at participating sites and contributed to data acquisition. SS conceived the original project, scientific design, analysis plan and reviewed multiple drafts of the paper. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

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Correspondence to
Shetal Shah.

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Damodaran, K., Brumberg, H.L., Jawale, N. et al. Comparison of birth outcomes of mothers covered by Medicaid versus those privately insured when accounting for social determinants of health.
J Perinatol (2023). https://doi.org/10.1038/s41372-023-01842-x

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  • Received: 15 June 2023

  • Revised: 15 November 2023

  • Accepted: 24 November 2023

  • Published: 11 December 2023

  • DOI: https://doi.org/10.1038/s41372-023-01842-x

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