Article Review: Adverse birth outcomes for all births went down in states that participated in the Medicaid expansion

A study in the June 2020 issue of Medical Care by Clare Brown and colleagues finds that after Medicaid expansion, county-level adverse birth outcomes for all births went down in states that participated in the Medicaid expansion.

For this study, low birth weight (<2500 g) and preterm births (37 weeks gestation) were the variables used to describe adverse birth outcomes. According to the World Health Organization, low birth weight and preterm birth is the most common direct cause of neonatal mortality worldwide. Reducing the rate of all infant deaths and total preterm live births were part of the Healthy People 2020 leading health indicators.

The authors for this June 2020 study used county-level rates of low birth weight and preterm birth outcomes from 2011 to 2016. The Birth Data Files contained information from 100% of births registered in all 50 states and the District of Columbia. From those files, the authors excluded noncontiguous states, states that expanded Medicaid after January 1, 2014, and 9 independent cities without a county. Mothers 18 and under were excluded as were counties with fewer than 30 births.

Overall, adverse birth outcomes were lower within Medicaid expansion states versus states that did not participate in the Medicaid expansion. Additionally, there were disparities among black infants relative to white infants, whether or not the state…