4001.0: Tuesday, October 23, 2001 - Board 8

Abstract #31415

A Case-Control Study Evaluating the Association between Infant Mortality and Mothers' Participation in Medicaid, WIC and Food Stamps Program during Pregnancy in Missouri during 1989-1997

Jeya Sophia Yogaraj, School of Public Health, Saint Louis University, 1342-A McCutcheon Road, Saint Louis, MO 63144, 314-918-9303, jsyogaraj@hotmail.com

Objective: This study evaluated whether mothers who were enrolled in Medicaid, Special Supplemental Nutrition Program for Women, Infants and Children(WIC) and Food Stamps program during pregnancy experienced different infant mortality risks when compared to mothers who did not participate in any of these programs. Methods: 4678 infant mortality cases and 4839 controls were selected for this population-based case-control study using linked infant birth and death certificates of Missouri residents between 1989 and 1997. Association between infant mortality and government program participation was estimated using a logistic regression model. Results: WIC only, Medicaid only or WIC+Medicaid participants had infant mortality risks similar to non-government program participants. Mothers who participated in Food Stamps only[adjusted odds ratio(aOR)=1.4, 95% confidence interval(CI)=0.8-2.6], Food Stamps+Medicaid(aOR=2.0,CI=1.5-2.6), Food Stamps+WIC(aOR=1.7,CI=1.0-3.0), or all three government programs(aOR=1.7,CI=1.4-2.0) had higher infant mortality risks. Mother's race, education level, marital status, and inadequate prenatal care were identified as confounders. Mothers with less than 12 years of education(aOR=1.2,CI=1.1-1.4) and inadequate prenatal care(aOR=1.7,CI=1.5-1.9) had higher infant mortality risks. Conversely, white mothers(aOR=0.8,CI=0.7-0.9) and mothers married to infants' fathers(aOR=0.8,CI=0.7-0.9) had lower infant mortality risks. Conclusions: WIC and/or Medicaid enrollment should be considered beneficial for low-income women since these program participants have infant mortality rates similar to those in the reference group. Food Stamps mothers, regardless of their enrollment in WIC or Medicaid, were more likely to have a child that died within the first year of life. Larger studies are needed to confirm the trends seen in this study.

Learning Objectives: Characteristics of women enrolled in the Food Stamps program during pregnancy might be different from WIC, Medicaid or non-governmental program participants. In this study, Food Stamps mothers had higher infant mortality even when they received all governmental support.

Keywords: Infant Mortality, Medicaid

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA