SCHS Studies NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

Objectives: This study compares the prevalence of high neonatal risk among very-low-birth-weight babies (VLBW) referred to North Carolina’s Infant/Toddler Program and those VLBW babies not referred to the program. The study also compares demographic and socioeconomic characteristics of mothers with VLBW babies referred and not referred to the program. Methods: The sample for this study was obtained from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The study design incorporates a case-control approach. High neonatal risk includes birth weight less than or equal to 800 grams, gestational age less than or equal to 28 weeks, and extended infant hospitalization after birth (75+ days). For the study period, July 1997 through December 1999, there were 616 VLBW PRAMS babies. The case group consisted of 200 of these infants whose birth certificate name and date of birth matched to the Infant/Toddler service records, leaving 416 infants in the control or non-Infant/Toddler group. Results: No significant demographic differences were found among mothers with VLBW babies in the Infant/Toddler and non-Infant/Toddler groups. The prevalence rates for extreme low birth weight, extreme preterm birth, and extended infant hospitalization after birth were all significantly higher in the Infant/Toddler group. Among the four low socioeconomic indicators, two were significantly elevated in the Infant/Toddler group: Medicaid payment for prenatal care and annual household income below $12,000. Conclusion: The study confirms that high neonatal risk is strongly associated with an infant being referred to North Carolina’s Infant/Toddler program. Monitoring program coverage rates for extremely low birth weight and extremely preterm babies over time will help assess program efforts to enhance coverage of this high risk population.