Published online July 1, 2008
PEDIATRICS Vol. 122 No. 1 July 2008, pp. e100-e106 (doi:10.1542/10.1542/peds.2007-1314)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pittard, W. B.
Right arrow Articles by Laditka, S. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pittard, W. B., III
Right arrow Articles by Laditka, S. B.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Associations Between Maternal Age and Infant Health Outcomes Among Medicaid-Insured Infants in South Carolina: Mediating Effects of Socioeconomic Factors

William B. Pittard, III, MD, PhD, MPHa, James N. Laditka, DA, PhD, MPAb and Sarah B. Laditka, PhD, MA, MBAc

a Division of Pediatric Epidemiology and Health Systems Research, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
b Departments of Epidemiology and Biostatistics
c Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

OBJECTIVE. The objective of this study was to investigate whether infants who are born to adolescent mothers are at greater risk for health problems than those who are born to older mothers.

METHODS. Data represent all health care encounters for infants who were born in South Carolina between 2000 and 2002 and were healthy at birth and continuously enrolled in fee-for-service Medicaid (n = 41696). We separately examined in the first and second years of life use of preventive care doctor visits, sick-infant doctor visits, emergency department visits, hospital admissions, and both emergency department visits and hospitalizations for ambulatory care–sensitive conditions. We compared these outcomes for infants of adolescent mothers (aged 11–17 years) and older mothers (aged 18–47 years), adjusting for individual characteristics of mothers and infants.

RESULTS. In unadjusted results, infants of adolescent mothers used more health care in 9 of 12 use categories. For example, in year 1, they had an average of 1.71 emergency department visits and 1.39 hospitalizations, compared with 1.26 and 1.18, respectively, for infants of older mothers. In results that were adjusted only for infant and delivery characteristics, they similarly used more services in most categories. After adjustment for either mothers' characteristics alone or those of both the infant/delivery and mothers, there was evidence that they had modestly more sick-infant doctor visits and hospital admissions in year 1 and notably more hospital admissions for ambulatory care–sensitive conditions.

CONCLUSIONS. Infants of adolescent mothers are more likely than infants of older mothers to use a variety of health care services that suggest poorer health. A considerable proportion of this greater use seems to be attributable to specific characteristics of mothers, such as socioeconomic characteristics, rather than to an inability that is common among adolescents to promote infant health or to use health care appropriately.

Key Words: Medicaid • adolescent mothers • infant health care • socioeconomic status • ambulatory care sensitive conditions

Abbreviations: ED—emergency department • FFS—fee for service • ACSC—ambulatory care–sensitive condition • FPL—federal poverty level • EPSDT—Early and Periodic Screening, Diagnosis, and Treatment • AAP—American Academy of Pediatrics • RR—rate ratio • CI—confidence interval

Accepted Jan 2, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?