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

Abstract

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.