MATERNAL & CHILD HEALTH
INFANT MORTALITY IN MISSISSIPPI: POTENTIAL STRATEGIES TO IMPROVE INFANT HEALTHInfant mortality continues to be a significant public health problem in Mississippi. Infant death rates in the state remain the highest in the U.S., despite recent declines in the state’s rate to a low of 8.8 deaths per 1,000 live births.
The Center for Mississippi Health Policy partnered with the Mississippi State Department of Health to analyze the available data on infant mortality and other poor birth outcomes and estimate the associated economic costs to the state.
- Birth defects, low birth weight, preterm birth, sudden infant death syndrome, accidents (including suffocation), and maternal complications are the leading causes of infant mortality in Mississippi
- Although 14 percent of all births in Mississippi are low or very low birth weight, 67 percent of infant deaths are below normal birth weight
- The infant death rate for preterm births is ten times higher than for births at full term
- Medical care costs associated with premature births are estimated to cost $241 million annually in Mississippi, most of which (85%) are incurred during the first few weeks of life
- Underdeveloped babies are not only at higher risk for infant death, but also for developmental problems—which can require early intervention and special education services. These support services are estimated to cost $22 million annually in Mississippi
- Poor birth outcomes are driven by several risk factors which are amenable to preventive efforts:
- Poor health status of the mother before pregnancy
- Tobacco use during pregnancy
- High rates of early elective deliveries
- High risk births in hospitals with an inappropriate level of care
- Sleep-related deaths
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Infant Mortality In Mississippi, Potential Strategies to Improve Infant Health (January 2014)
EARLY ELECTIVE DELIVERIES IN MISSISSIPPI: IMPACT ON HEALTH AND MEDICAL CARE COSTS
EARLY ELECTIVE DELIVERIES IN MS
The growing practice of early delivery of infants for non-medical reasons is associated with higher rates of newborn admissions to hospital intensive care units and neonatal deaths. As a result, the American College of Obstetricians and Gynecologists recommends scheduling elective deliveries until at least 39 weeks of gestation.
The Center for Mississippi Health Policy partnered with the Mississippi State Department of Health to analyze the available data on early elective deliveries in Mississippi. Data on birth trends, medical care costs, and best practices in use by other states were reviewed.
- Mississippi reflects trends found nationwide, as all births at 37 and 38 weeks of gestation climbed significantly (p<0.01) from 2001 to 2011. During the same time frame, all births at 39 weeks or later — elective or not — declined significantly (p<0.01).
- From 2001 through 2011, early elective deliveries doubled statewide.
- Babies born electively in Mississippi during 37 and 38 weeks of gestation had significantly higher death rates (p<0.05) within the first month of life compared to babies born at 39 weeks.
- National data document higher neonatal intensive care admission rates for babies born electively during 37 and 38 weeks of gestation.
- Some states have established policies which resulted in declines in the rate of early elective deliveries among Medicaid beneficiaries and have projected millions of dollars in cost savings as a result.
DEVELOPMENTAL SCREENING IN EARLY CHILDHOOD
The Center for Mississippi Health Policy commissioned Mississippi State University’s Social Science Research Center (SSRC) to conduct a study implementing developmental screening in each of the eleven Pre-Kindergarten Early Learning Collaboratives funded by the State. The goal of the study was to determine the developmental concerns of children entering Pre-K in Mississippi and the policy implications that these needs have for the state.
The project used the Ages and Stages Questionnaires, Third Edition (ASQ-3) and the Ages and Stages Questionnaire: Social-Emotional (ASQ-SE). These widely used instruments are considered valid and reliable for assessing developmental progress for children ages 1 month to 5 years. Of the 1,786 children who attended the Pre-K Collaboratives in 2014, approximately 1,350 children were screened.
Findings from the ASQ-3 screenings indicate that nearly one-quarter (24%) of children screened scored in the “Referral” range, indicating they needed a comprehensive assessment to determine the nature of a potential developmental delay. Another quarter (24%) had scores in the “Monitor” range, meaning they should be provided targeted attention and re-screened. The remaining half (52%) scored in the “On Target” group, indicating typical development.
MIDWIFERY & BIRTH CENTERS IN MISSISSIPPI
Mississippi, like many states, has a shortage of obstetric providers especially in rural areas. The majority of births in the state occur in metropolitan areas and are delivered by obstetrician-gynecologists (OBGYNs). Pregnant women in over half of the counties in the state must travel outside their county to see an OBGYN for prenatal care and delivery services.
Planned births occurring outside of a hospital setting in Mississippi increased by 68% from 2007 to 2017. Midwives attend and manage births planned to take place in homes and community settings.
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PUBLICATIONSCopies of the issue briefs, chartbooks, and reports can be downloaded here. Printed copies of all documents are available by contacting the Center for Mississippi Health Policy at 601-709-2133 or by e-mail at firstname.lastname@example.org.
- Midwifery Care & Birth Centers (May 2020)
- Childhood Development Implementing Screening In Mississippi Pre-kindergarten Programs (June 2015)
- Infant Mortality In Mississippi, Potential Strategies to Improve Infant Health (January 2014)
- Early Elective Deliveries in Mississippi, Impact on Health and Medical Care Costs (November 2013)