MATERNAL & CHILD HEALTH

OVERVIEW

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 STUDY

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.

RESULTS

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.

INFANT MORTALITY IN MISSISSIPPI: POTENTIAL STRATEGIES TO IMPROVE INFANT HEALTH

Infant 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.

KEY FINDINGS

  • 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

EARLY ELECTIVE DELIVERIES IN MISSISSIPPI: IMPACT ON HEALTH AND MEDICAL CARE COSTS

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.

KEY FINDINGS

  • 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.

PUBLICATIONS

Copies 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 info@mshealthpolicy.com.

Issue Briefs:

Reports: