Risk of death due to birth defects higher if baby covered by Medicaid

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THURSDAY, Jan. 26, 2017 — Severe birth defects cause about one in every five infant deaths in the United States. Now, new research finds that the odds for one of these tragic events rise if a newborn is covered by Medicaid rather than private insurance.

For babies born at term, deaths due to birth defects “were approximately 45 percent higher for deliveries covered by Medicaid than those covered by private insurance,” said a team led by Lynn Almli. She’s from the National Center on Birth Defects and Developmental Disabilities, part of the U.S. Centers for Disease Control and Prevention.

Medicaid is the publicly funded insurance program for the poor.

Severe birth defects are rare, but can include heart defects; central nervous system defects such as spina bifida; or chromosomal abnormalities that can result in severe mental and/or physical disabilities.

The new study sought to determine if a family’s insurance status had any impact on a baby’s risk of dying from a birth defect.

Almli’s team looked through 2011-2013 payment data for more than 9.5 million deliveries recorded in more than 30 states and the District of Columbia.

In more than 53,000 of these cases, the baby later died in infancy. About 11,000 of those deaths (21 percent) were attributed to a birth defect.

Almli and her colleagues found that compared to infants born to parents with private insurance, babies born at term with a birth defect to families covered by Medicaid had 45 percent higher odds of dying in infancy. This was true regardless of the category of birth defect, the researchers said.

Why the disparity?

According to the study authors, the reasons are not known, but might include insurance-linked gaps in “access to and utilization of preconception health care, prenatal screening, and termination of pregnancies for fetal anomalies.”

Changes in a family’s insurance policies or Medicaid coverage over time might also have had an influence, the researchers added.

Whatever the reason, Almli and her team said no family should be at higher risk of such tragedies simply because of their insurance status. “Strategies need to be implemented to reduce [birth defect deaths] for all deliveries, regardless of payment source,” they wrote.

The study was published Jan. 26 in the CDC journal Morbidity and Mortality Weekly Report.

More information

Find out more about birth defects at the March of Dimes.

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