“There are disparities in the health and survival of babies with birth defects depending on their race, ethnicity, and socioeconomic status,” says Paul E. Jarris, MD, MBA, senior vice president for Maternal Child Health Impact and deputy medical officer of the March of Dimes, which was involved in today’s study. “In this study, payment status at delivery is used to identify infants at higher risk for poor health outcomes. While March of Dimes strives for a world where every baby has a fair chance, this is not the reality for too many mothers and babies in our nation.”
The authors of the study say 81 percent of live births and 75 percent of infant deaths in the U.S. from 2011 to 2013 were captured in their analysis of data from the CDC’s National Center for Health Statistics. Rates of infant mortality due to birth defects (IMBD) were examined by gestational age at birth (term and preterm, which is defined as less than 37 weeks of pregnancy); payer of delivery (private health insurance or Medicaid); age at death (neonatal, or one month or less; and postneonatal, or one month to one year); and specific birth defects. The study found that IMBD rates were higher for babies whose deliveries were paid for by Medicaid compared to private insurance. Among term infants, neonatal and postneonatal IMBD rates were approximately 45 percent higher for deliveries covered by Medicaid than those covered by private insurance. A similar difference was observed in preterm infants who died in the postneonatal period.
“Babies born with birth defects often need specialized care, including access to pediatric subspecialists experienced in managing such disorders,” Dr. Jarris says. “This study confirms the disproportionate risk of death from birth defects among infants born to low-income mothers. More research studies are needed to understand the reasons for these differences. We have an opportunity to examine what more can be done to prevent birth defects and save the lives of babies born with these conditions, regardless of payment source for delivery.”
Birth defects affect 1 in every 33 babies born each year in the U.S. Results from today’s study show that approximately 12 infant deaths related to birth defects occur for every 10,000 babies born. Common birth defects include congenital heart defects, cleft lip and cleft palate, and spina bifida. January is Birth Defects Prevention Month, a time when the March of Dimes and CDC focus on steps women can take to prevent birth defects, such as taking a multivitamin containing folic acid every day before and during early pregnancy, and protecting themselves from common infections such as Zika virus.
“Association Between Infant Mortality Attributable to Birth Defects and Payment Source for Delivery—United States, 2011–2013,” appeared in the January 26, 2017 issue of MMWR. The authors were Lynn M. Almli, Caroline C. Alter (March of Dimes), Rebecca B. Russell (March of Dimes), Sarah Tinker, Penelope P. Howards, Janet Cragan, Emily Petersen, Gerard E. Carrino, and Jennita Reefhuis.