Exploring How Mothers and Infants Use Preventive Care in Adult and Pediatric Settings

Statement of Problem

There is a growing understanding that preventive care is crucial to improve pregnancy outcomes, decrease health care costs and increase health equity. Yet, only one-third of women report receiving comprehensive preventive care in the year prior to their first birth, and even fewer report receiving such care in between pregnancies. For women, optimizing health in this period may improve outcomes in future pregnancies, improve their long-term cardiovascular health and ensure they have the ability to provide the best care for their child. For infants, their early growth and development predicts how healthy they will be in the future, much of which is dependent on their parents’ health.

In the year following birth, women interact with the health care system both as patients in adult settings and as parents in pediatric settings. Pediatricians are increasingly asked to identify and address maternal health issues such as postpartum depression, yet women may also receive care in adult settings. Despite this overlap, coordination between adult and pediatric settings around preventive health for families is rare, leading to potential gaps in mother-infant services. Establishing ways for pediatric and adult care providers to coordinate on how they deliver preventive care services may improve birth outcomes and the health of both women and babies.

Description

This project addresses the lack of coordination between adult care and pediatrics by identifying preventive care opportunities from the mother-infant dyad perspective in the year after birth. Prioritizing at-risk populations, our study specifically looks at outcomes for women treated for depression, anxiety, obesity, diabetes or hypertension during pregnancy or in the first three months postpartum, and women who had a preterm birth. Children whose parents experience these conditions are more likely to develop the conditions themselves, emphasizing the importance of medical services for these new parents and families.

During the first part of the study, we will use Medicaid data of mother-infant pairs to look at the number of preventive visits for the first year after birth including postpartum care, contraception or generalized attention to maternal health risk. For the purposes of this analysis, we will consider any care billed to the child’s health insurance as pediatric care and any care billed to the mother’s insurance as adult care. Our measures will help us identify patterns of when and how women are receiving preventive care between pregnancies and where gaps exist. We can use this information to develop tailored programs to address critical needs during the interconception time period.

Next Steps

It is our hope that using the results of this study, we can assist both pediatric and adult systems in better-positioning how they provide coordinated, comprehensive preventive care for mother-infant pairs during the first year after birth. We know that kids do better when their parents do better and interventions during this time have the potential to change long-term health trajectories for both caregivers and their children.

This project page was lasted updated in October 2019.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Exploring How Mothers and Infants Use Preventive Care in Adult and Pediatric Settings [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here]. 

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