To estimate Prenatal Care Coordination’s (PNCC) effect on birth outcomes for Wisconsin Medicaid‐covered deliveries.
A longitudinal cohort of linked Wisconsin birth records (2008‐2012), Medicaid claims, and state‐administered social services.
We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestational age (completed weeks), and preterm birth (<37 weeks). We estimated PNCC′s effect on birth outcomes, adjusting for maternal characteristics, using inverse‐probability of treatment weighted and sibling fixed effects regressions.
Data Collection/Extraction Methods
We identified 136 224 Medicaid‐paid deliveries, of which 33 073 (24.3 percent) linked to any PNCC claim and 22 563 (16.6 percent) linked to claims for PNCC service uptake.
Sibling fixed effects models—which best adjust for unobserved confounding and treatment selection—produced the largest estimates for all outcomes. For example, in these models, PNCC service uptake was associated with a 1.3 percentage point (14 percent) reduction and a 1.8 percentage point (17 percent) reduction in the probabilities of low birthweight and preterm birth, respectively (all < .05).
PNCC′s modest but significant improvement of birth outcomes should motivate stronger PNCC outreach and implementation of similar programs elsewhere.
