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Neonatal outcomes after preterm birth by mothers' health insurance status at birth: a retrospective cohort study

Publicly insured women usually have a different demographic background to privately insured women, which is related to poor neonatal outcomes after birth.

Authors:
Einarsdottir K, Haggar F, Langridge A, Gunnell A, Leonard H, Stanley F

Authors notes:
BMC Health Services Research. 2013;13(1):40

Keywords:
Health insurance, preterm birth, Neonatal outcomes, Apgar score, Neonatal resuscitation

Abstract:
Publicly insured women usually have a different demographic background to privately insured women, which is related to poor neonatal outcomes after birth.

Given the difference in nature and risk of preterm versus term births, it would be important to compare adverse neonatal outcomes after preterm birth between these groups of women after eliminating the demographic differences between the groups.

Compared with infants of privately insured women, infants of publicly insured women were more likely to receive a low Apgar score and take longer to establish unassisted breathing, yet, they were less likely to be admitted to a special care unit.

No significant differences were evident in neonatal resuscitation between the groups.

The underlying reasons for the lower rate of special care admissions in infants of publicly insured women compared with privately insured women despite the higher rate of low Apgar scores is yet to be determined.

Future research is warranted in order to clarify the meaning of our findings for future obstetric care and whether more equitable use of paediatric services should be recommended.