Project designed to prevent pre-term births in at-risk recipients

Monday, April 22nd, 2013. Filed under: Baby Health Giving Birth Pregnancy

MP900289365When babies are born too early, they are more likely to have serious health problems or to die.  To combat this problem, the Alabama Medicaid Agency is teaming up with the state’s maternity care providers to reduce the number of premature, or pre-term, births among Medicaid-eligible women.

The two-year project, which began February 1, is based on the American College of Obstetricians and Gynecologists’ recommendation that all pregnant women with a prior history of a spontaneous pre-term birth at 37 or fewer weeks gestation be counseled on the benefits of taking 17-Alpha Hydroxyprogesterone Caproate, or “17P” to prevent a second pre-term birth.

“Preterm birth is associated with long-term problems such as neurologic handicaps, blindness, deafness, and chronic respiratory disease among others, especially in births before 30 weeks gestation,” said Medicaid Medical Director Dr. Robert Moon. He noted that conditions related to short gestation and low birth weight are the leading cause of infant death, based on a 2009 study conducted by the Alabama Perinatal Program.

In Fiscal Year 2011, the Alabama Medicaid Agency financed more than 50 percent of all deliveries in the state. Of the 31,028 Medicaid deliveries, 3,538 babies – 11 percent – received care in a neonatal intensive care unit at a cost of $57.8 million, or an average cost of $16,345 per baby. 

According to Dr. Moon, the project has two goals:  One is to help identify and refer maternity patients at risk for preterm births and the second is to determine the use of 17P and the pregnancy outcomes in this population.

The first phase of the project will take place between February 1, 2013 and September 30, 2013. During this phase, maternity care coordinators will be trained to screen, educate and refer maternity patients at risk of having a pre-term birth. If a patient is at risk of a pre-term birth, a copy of the screening tool used will be provided to the patient’s medical provider for follow-up. After the screening and education process, data will be collected to determine how many patients were screened, how many recipients received educational materials and how many were referred to their delivering health care provider.

In the second phase of the project, the Agency will determine how many recipients who were referred actually received the medication and if the number of pre-term births among at-risk patients improved while receiving the drug. This phase is scheduled to begin December 1, 2013 and continue through July 13, 2014.