RESUMEN
OBJECTIVES: The objective of this study was to determine if severe mental illness and/or a history of substance use in mothers of babies of a healthy weight was associated with infant mortality. STUDY DESIGN: This was a cross-sectional observational study using CareSource historical billed Medicaid Managed Care plan (MMC) claims in Ohio. METHODS: CareSource is Ohio's largest MMCP, serving approximately 1.2 million Medicaid consumers. Claims from 89,159 babies of a healthy weight (≥ 2500 grams) and their mothers were selected from the CareSource Ohio MMCP population from January 2011 through December 2014. The mental health and substance abuse status of the mother was identified from claim history. A logistic regression model was used to estimate the odds ratio for infant mortality based on the presence or absence of maternal severe mental illness (MSMI) or maternal substance abuse (MSU). RESULTS: The logistic regression model fit showed that the odds of infant mortality for infants born weighing 2500 grams or more was significantly higher when the mother was treated either for MSMI (χ2(1): P = .026) or MSU (χ2(1): P = .006) at any time before or after delivery. CONCLUSIONS: Findings indicate that to address infant mortality, a focus on only babies born premature or low birth weight will result in missing a notable segment of the population that requires attention. Mothers who have babies with a healthy weight of at least 2500 grams, but who are diagnosed with either MSMI or MSU, need at least equal attention if inroads are to be made in reducing infant mortality.