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Am J Perinatol
DOI: 10.1055/a-2729-1082
Original Article

Postpartum Care Utilization among Medicaid-Insured Birthing People with an Infant Hospitalized in the NICU

Autoren

  • Devlynne S. Ondusko 

    1   Department of Pediatrics, Division of Neonatology, Oregon Health & Science University, Portland, Oregon, United States

  • Julianna Mazziotti

    2   School of Medicine, Oregon Health & Science University, Portland, Oregon, United States

  • Ann Martinez Acevedo

    3   Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, United States

  • Ashley Daly

    3   Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, United States

  • Maria I. Rodriguez

    4   Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, United States

Funding Information This work was supported by the Oregon Health & Science University Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of Oregon Health & Science University.
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Abstract

Objective

This study aimed to determine the association of neonatal intensive care unit (NICU) admission with subsequent postpartum care among Medicaid recipients.

Study Design

Retrospective cohort study using linked Medicaid claims and birth certificate data from Oregon and South Carolina, 2010 to 2020. Outcomes were postpartum care attendance, contraception, emergency department (ED) utilization, and readmission. Linear regression models evaluated the association between NICU admission and postpartum care.

Results

Our sample included 457,102 birthing people, 37,035 (8.1%) of which had a NICU-admitted infant. Medicaid recipients with NICU-admitted infants had higher rates of cesarean section, pregnancy complications, postpartum mental health conditions, and substance use. No significant differences in postpartum care attendance were noted, but NICU admission was associated with 6% greater ED use (95% CI: 0.052, 0.068, p < 0.001) and 3% higher readmission (95% CI: 0.026, 0.034, p < 0.001).

Conclusion

Postpartum care receipt was similar, but ED and readmission rates are higher among those with NICU-admitted infants. Preventative postpartum care approaches must improve for at-risk populations.

Key Points

  • Medicaid recipients have similar routine postpartum care attendance regardless of NICU admission.

  • Postpartum patients with a NICU-admitted infant have greater ED utilization.

  • Postpartum patients with a NICU-admitted infant have higher readmission rates.

Keywords

postpartum care - NICU - disparities - health services

Data Availability Statement

Deidentified individual participant data will not be made available.


Contributors' Statement

D.O.: conceptualized and designed the study, performed interpretation of the data, drafted the initial manuscript, and critically reviewed and revised the manuscript; J.M.: conceptualized and designed the study, participated in interpretation of the data, participated in initial draft of the manuscript, and critically reviewed and revised the manuscript; A.M.A.: collaborated in design of the study and data analysis plan, performed statistical analysis, performed interpretation of the data, and participated in initial draft of the manuscript, and critically reviewed and revised the manuscript; A.D.: collaborated in design of the study and data analysis plan, performed statistical analysis, performed interpretation of the data, and participated in initial draft of the manuscript, and critically reviewed and revised the manuscript; M.R.: collaborated in design of the study and data analysis plan, performed interpretation of the data, and participated in initial draft of the manuscript, and critically reviewed and revised the manuscript.


Ethical Approval

Oregon Health & Science University IRB approval was obtained, STUDY00027022.


Informed Consent

Study subject consent was waived by the IRB. The study was performed in accordance with the Declaration of Helsinki.


Supplementary Material



Publikationsverlauf

Eingereicht: 07. August 2025

Angenommen: 21. Oktober 2025

Artikel online veröffentlicht:
04. November 2025

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