Outcomes for Newborns Born to Adolescents and Young Women in the Military Health System

Background: Infants born to adolescent mothers represent 15.3 per 1,000 births in the United States.1 Newborns born to young mothers are at risk are for prematurity, low birth weight and for being small for gestation age.2,3 Under the Patient Protection and Affordable Care Act (2010), eligible dependents could remain on their parent’s health care plan until age 26 which expanded maternity care and access for military dependents. Few studies have been performed examining neonatal outcomes in infants born to adolescent and young adult military beneficiaries. The purpose of this study was to examine neonatal outcomes of infants born to adolescent and young adult women in the military health system and compare these to national outcomes. We hypothesize that given these adolescents and young adults have access to low to no cost health care , neonatal outcomes may be improved.

Methods: We performed a retrospective chart review for all singleton deliveries born at our facility to women 26 and younger between October 2015 and December 2020. To be eligible for care at our facility, mothers must be active duty, an active-duty spouse, or a child of an active-duty service member. The electronic medical record was queried for maternal age, documentation of chorioamnionitis, gestational age, documentation of prematurity ( <37 weeks), birthweight percentile (small for gestational age, average for gestation age, large for gestation age), NICU admission, neonatal death, hypoglycemia, respiratory distress or failure, sepsis work-up or screen , cardiac malformation, hypothermia, or a CPS referral.

Results: There were 2107 newborns that met our eligibility criteria. 331 newborns were born to a military dependent daughter while 1776 were born to active-duty mothers and spouses. There was no significant difference in gestational age at birth, incidence of prematurity, birthweight percentile, occurrence of a NICU admission, neonatal death, hypoglycemia, respiratory distress or failure, sepsis screen, congenital cardiac disease or hypothermia based on maternal age (Table 1). A maternal diagnosis of chorioamnionitis, sepsis work-up and a CPS referral was associated with maternal age (Table 1). In comparison to published national outcomes and data, there was a significant smaller occurrence of preterm births, SGA and LGA births but a higher occurrence of NICU admissions (Table 2) .

Conclusion: Newborns born to adolescent and young adult military beneficiaries have improved neonatal outcomes in comparison to national published data. These results may correlate to improved maternal access to a comprehensive free health care system.