Data Plenary

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Data Plenary

• Maternal and Infant Mortality Summit
• 10-24-2007

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Infant Mortality Rate Ratios for Select Ethnic
and Racial Groups
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IL PRAMS 2004
IL PRAMS 2004
IL PRAMS 2004
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Live Births and Infant Deaths by Gestational Age
IL 2004


Early Preterm defined as lt 33 weeks
gestation Late Preterm defined as 34-36 weeks
gestation
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Singleton Prematurity Birth Rate and Ratios
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If the preterm birth rate in all groups was the
same as it is for Mexican infants (8.2) (using
2004 matched birth-death data)

• Non-Hispanic Black Infants
• (reducing preterm births from 15.0 to 8.2)
• The infant mortality rate (IMR) would drop from
  14.6 to 10.0 per 1,000 live births
• 142 excess deaths to preterm Non-Hispanic Black
  infants
• Non-Hispanic White Infants
• (reducing preterm births from 10.3 to 8.2)
• IMR would drop from 5.9 to 5.1 per 1,000 live
  births
• 78 excess deaths to preterm Non-Hispanic White
  infants
• Puerto Rican Infants
• (reducing preterm births from 13.5 to 8.2)
• IMR would be halved
• 12 excess deaths to preterm Puerto Rican infants

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Live Births and Infant Deaths by Birth Weight IL
2004
Low Birth Weight
Normal Birth Weight
Births
Deaths
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Consequences of Low Birth Weight

• cerebral palsy (25 times more common)
• deafness
• blindness
• epilepsy
• chronic lung disease
• learning disabilities
• attention deficit disorder
• death during infancy
• Source The Future of Children (5)1 Spring 1995

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Risk Factors of Medicaid-Eligible Women of
Child-Bearing Age
Maternal Age Risk (15-17, 36-45 ) 35.8
Complication of Previous Pregnancy 26.9
Depression 19.6 Drug Abuse
16.4 Asthma 14.3
Mental Health Disorder 9.4 Uterine
Bleed 8.7 Cardiovascular
8.0 Threatened Pre-term Labor 6.9
Hypertension 6.0
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HFS Women who Delivered in CY 2004 2005 (N
156k) Factors Contributing to Poor Outcome

• Complications of Previous Pregnancy
• Previous Very Low Birth Weight (lt 1500 gms)
• Previous Moderate Low Birth Weight (1501-2500
  gms)
• Incompetent Cervix
• Renal Complications
• Pregnancy Interspacing lt 18 Months
• Hypertension

Data Source MMIS Paid Claims History (SFY
1998-2005) HFS Deliveries File (CY 2004, 2005)
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HFS Women of Childbearing Age (15-45 Yrs)
(N686k)Previous Non-Normal Births (N13,500)
(2)
Non-Normal Births Identified by DRGs
DRG 386 or 986 - EXTREME IMMATURITY OR RESP
DISTRESS SYNDROME DRG 387 or 987 - PREMATURITY
WITH MAJOR PROBLEMS

Data Source MMIS Paid Claims History (SFY
1998-2007) Eligibility File (Oct 2007)
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HFS Women who Delivered in 2004 2005 Cost of
Birth
With Risk Without Risk
Factors Factors Normal
Birth 3,388 2,844 Non Normal
28,541 18,376 Birth
Cost of Birth Moms delivery cost and Babys
birth cost
Data Source MMIS Paid Claims History (SFY
1998-2005) HFS Deliveries File (CY 2004, 2005)
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Distribution of Teen Births by Maternal Age
1994
2004
10-14
15-17
18-19
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Causes of Postneonatal Infant Death Illinois 2004
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If the Postneonatal SIDS death rate for
Non-Hispanic Black infants was the same as
Non-Hispanic White infants (33.6 per 100,000)
(using 2005 death data)

• Non-Hispanic Black Infants
• (reducing Postneonatal SIDS rate from 132.6 to
  33.6)
• Postneonatal mortality rate would drop from 5.5
  to 4.6 per 1,000 live births.
• 30 excess postneonatal SIDS deaths among Black
  infants

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Summary

• In Illinois we have to address the long standing
  racial disparity, regardless of income
• We need to address the disparities in premature
  birth, SIDS and unintentional injuries
• We need to address the Emerging disparity among
  Puerto Rican infants
• Short intervals between pregnancies and teen
  pregnancy remain important risk factors
• There are improvements needed in preconceptional,
  prenatal and perinatal care.

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The Challenge

• What must we do to reach the national goal of 4.5
  infant deaths per 1,000 live births?
• What causes underlie the racial and ethnic
  disparities in Illinois infant mortality rate,
  and what new strategies will we employ to
  eliminate them?
• What policies need to be developed and
  implemented to improve the health of all families
  in Illinois.

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Acknowledgements

• The Summit Data Committee wishes to thank Kyle
  Garner and Alicia Henderliter of the Illinois
  Department of Human Services, Theresa Sandidge
  and Helen Schmidt of the Illinois Department of
  Public Health, and Katey Staley, Laura Roberts
  and Nivedita Baliga of the Illinois Department of
  Healthcare and Family Services for their
  assistance in preparing the analyses used in this
  presentation.