Mother’s Bipolar Diagnosis During Pregnancy is a Top Predictor of Medicaid Infant Hospitalization

WILMINGTON, Del.–(BUSINESS WIRE)–#bipolar–A top predictor of Medicaid infants being hospitalized six months after
their hospital birth discharge is their mother’s bipolar diagnosis
during pregnancy, according to a study published in Hospital

The main predictor of hospitalization was for those infants who had
spent some time in the neonatal intensive care unit, which was an
expected outcome and one that is difficult to influence. Many factors,
such as how often a pregnant mother visited the Emergency Department and
how often she was admitted to the hospital played a role in increasing
the chances of infants being hospitalized after birth.

The study was authored by representatives from Christiana Care Health
System, Sidney Kimmel Medical College at Jefferson University,
HealthCore, Inc., the Delaware Department of Health and Social Services,
Division of Medicaid and Medical Assistance and the University of
Wisconsin. The study is a retrospective observational analysis of
infants born between 2009 and 2012 using claims data and electronic
hospital records for clinical data not routinely recorded in claims data.

“Re-hospitalizations and Emergency Department visits are stressful to
the family and costly to the payer,” said Dr. David Paul,
study author and clinical leader, Women and Children’s Service Line,
Christiana Care Health System. “This study is important because it
provides Medicaid programs guidance in tailoring interventions toward
specific populations of mothers to improve the health of infants and
their mothers and help prevent re-hospitalizations and Emergency
Department visits.”

While a small number of mothers – 6 percent – were actually diagnosed
with bipolar disorder during pregnancy, another 14 percent were
depressed and 31 percent had another mental health disorder. Any
indication of a mother’s mental health problem during pregnancy
increased the likelihood for her infant’s re-hospitalization or
Emergency Department visits within the first six months.

“We know that feeling unprepared for parenthood is associated with
increased infant hospitalization and use of the Emergency Department, so
it’s important for us to look for ways to support new parents,
especially those struggling with mental health issues,” said Delaware
Department of Health and Social Services Secretary Rita Landgraf. “This
study speaks to the importance of the integration of behavioral health
care with primary care, and in this case, specialty care, and of
connecting individuals with the treatment services they need.”

Generally, during the first year of life, 4.4 percent to 9.5 percent of
infants are re-hospitalized with Medicaid patients at increased risk
compared with those with private insurance. For this study, 4 percent of
infants were re-hospitalized in 30 days and 11 percent in six months.
After discharge, 11 percent of the infants were seen in the Emergency
Department within 30 days and 41 percent within six months.

“Respiratory-related problems were the predominant reason for use of the
Emergency Department and re-hospitalization,” said Abiy Agiro, study
author and HealthCore research manager. “Newborns who had spent some
time in the NICU were most likely to be re-hospitalized after being sent

The study was authored by: Dr. David Paul, Dr. Matthew Hoffman and
Deborah Ehrenthal of Christiana Care Health System; Abiy Agiro, Michael
Pollack, and Christiana Boehmer of HealthCore; and Cynthia Denemark and
Dr. Anthony Brazen III of the Delaware Department of Health and Social
Services, Division of Medicaid and Medical Assistance. The study was
funded in part by AstraZeneca through its Real World Evidence
Collaboration with HealthCore.

About HealthCore, Inc.

HealthCore, Inc. is the wholly-owned, independently operating health
outcomes research subsidiary of Anthem, Inc. We work with life sciences
companies, payers and providers, and government and academic
organizations to provide real-world evidence in support of a wide
variety of health care decisions. Our research capabilities include
extensive experience in HEOR, Late Phase, Safety and Epidemiology and
Survey-Based research services and solutions with our work designed to
improve quality, safety and affordability in health care. With more than
20 years of experience, clinical and scientific research expertise, and
exclusive access to a robust, integrated research environment containing
information on nearly 60 million individuals from multiple health plans
across the U.S., HealthCore delivers unparalleled clarity and actionable
information to health care decision makers. To learn more about
HealthCore, go to


for HealthCore, Inc.
Lori McLaughlin