Risk factors for poorer birth outcomes in New York State counties

The purpose of this study is to identify significant factors that contribute to poorer birth outcomes among counties in New York State with the goal of highlighting trends and patterns that are particularly relevant in policy formulation, implementation, and evaluation. From 2004-2006 in New York State, 60 out of 1,000 females ages 15-44 gave birth. Five percent of these women received either late or no prenatal care. Furthermore, 8% of the infants of women who received late or no prenatal care were low birth weight defined as weighing less than 2500 grams. In 2005, the annual burden for preterm birth (before 37 weeks) cost an average of $51,600 per infant, totaling at least $26.2 billion for the United States as a whole. Using a secondary data set at the county level, obtained from multiple sources, this study analyzed the effects of socioeconomic factors, demographic factors, and health services on premature birth, low birth weight, and very low birth weight. Initial findings indicated that number of Medicaid providers, unemployment rate, and newborn drug related discharges had significant contributions to poorer birth outcomes. Such contributions are translated into monetary cost-savings: For instance, one additional Medicaid provider in Westchester County would decrease the number of LBW babies by 85 and save the county $4,386,000. These analyses are expected to contribute to public health nurses' awareness of maternal risk factors, particularly in rural counties, and to identify areas of need that can lead to policy recommendations.