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Premature infants born to adolescent mothers: health care utilization after initial discharge
Kristin N Ray1, Gabriel J Escobar, Scott A Lorch
1Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. rayk@email.chop.edu
Insights
Premature infants born to adolescent mothers face higher rates of rehospitalization and emergency department visits. This study highlights increased acute care utilization for this vulnerable population.
Area of Science:
- Neonatal Health
- Maternal Age Impact
- Healthcare Disparities
Background:
- Premature infants incur higher healthcare costs post-discharge than term infants.
- Young maternal age affects healthcare utilization in term infants, but its impact on premature infants is understudied.
- Adolescent mothers (aged ≤19) and young adult mothers (aged 20-29) represent distinct demographic groups with potentially different healthcare needs for their premature infants.
Purpose of the Study:
- To compare healthcare utilization between premature infants born to adolescent mothers and those born to young adult mothers.
- To investigate if adolescent maternal age is associated with increased acute care utilization (rehospitalizations, ED visits) and/or decreased preventive care utilization.
- To identify potential disparities in healthcare access and outcomes for premature infants based on maternal age.
Main Methods:
- Retrospective cohort study analyzing healthcare utilization data.
- Comparison of premature infants born to adolescent mothers (n=76) versus young adult mothers (n=587).
- Data collected from an integrated healthcare delivery system between 1998 and 2001.
Main Results:
- Premature infants of adolescent mothers showed significantly higher odds of medical rehospitalizations (OR 3.57) and emergency department visits (OR 3.67) within the first year post-discharge.
- Increased rehospitalization rates were particularly notable within the first three months after discharge (P < .001).
- No significant difference in the frequency of preventive care visits was observed between the two groups, even after controlling for illness severity.
Conclusions:
- Premature infants born to adolescent mothers experience significantly increased acute care utilization, including rehospitalizations and emergency department visits.
- Despite similar chronic illness severity and preventive care utilization, maternal age is a significant factor in post-discharge healthcare needs for premature infants.
- Findings suggest a need for targeted interventions and support for adolescent mothers to mitigate adverse healthcare outcomes in their premature infants.
Objective:
Premature infants have increased health care utilization after initial discharge compared with term infants. Young maternal age has been shown to impact health care utilization among term infants, but little is known about the impact of maternal age on health care utilization among premature infants. We compared health care utilization among premature infants of adolescent (aged < or = 19 years) and young adult (aged 20-29 years) mothers, hypothesizing that premature infants of adolescent mothers would have increased acute care utilization, while having decreased preventive care utilization.
Methods:
In this retrospective cohort study, we analyzed health care utilization of premature infants born to adolescent mothers (n = 76) compared with premature infants born to young adult mothers (n = 587) within a cohort of premature infants born between 1998 and 2001 in an integrated health care delivery system.
Results:
After controlling for illness severity, premature infants born to adolescent mothers had significantly increased odds of medical rehospitalizations (odds ratio 3.57, 95% confidence interval, 1.81-7.05) and emergency department visits (odds ratio 3.67, 95% confidence interval, 2.11-6.39) during the first year after initial discharge compared with premature infants born to young adult mothers. Differences in rehospitalization rates were significant within the first 3 months after discharge (P < .001). Frequency of preventive care visits was not significantly different between the two groups.
Conclusions:
Despite similar severity of chronic illness and similar preventive care utilization, premature infants born to adolescent mothers had significantly increased rates of rehospitalizations and emergency department visits compared with premature infants born to young adult mothers.
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