{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:33:02Z","timestamp":1747146782140,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017640","name":"DSHS","doi-asserted-by":"publisher","award":["NU50DD004942","NU50DD000102"],"award-info":[{"award-number":["NU50DD004942","NU50DD000102"]}],"id":[{"id":"10.13039\/100017640","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Birth defects are major contributors to healthcare resource use, disability, and mortality, particularly during the perinatal period. As the nation's public insurance program for low\u2010income individuals, Medicaid funds a large proportion of healthcare costs associated with birth defects. Here, we explore birth defect\u2010related factors associated with Medicaid participation in the first year of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Infants born with birth defects between 2010 and 2014 were linked from the Texas Birth Defects Registry to the state's Medicaid claims database. Variation in Medicaid participation was examined by individual birth defect and by birth defect characteristics. The associations between covariates and Medicaid participation are described using percentages and adjusted prevalence ratios (APR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 107,968 infants included in this study, 55,172 (51.1%) participated in Medicaid. Medicaid participation ranged from 12.1% for anencephaly to 77.8% for total anomalous pulmonary venous connection. An indicator of defect severity was associated with an increased likelihood of participation (APR\u00a0=\u00a01.22, 95% CI: 1.20\u20131.23). Medicaid participation was 60.8% for individuals with multiple major defects, compared with 45.4% for those without (APR\u00a0=\u00a01.24, 95% CI: 1.22\u20131.25). Among individual birth defects, Medicaid participation was almost universally higher for those co\u2010occurring with other major defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We detected large variations in Medicaid participation by individual birth defect. Infants participating in Medicaid tended to have more severe defects and were more likely to have multiple major defects. Medicaid claims databases can serve as valuable sources of data for surveillance efforts and observational studies, but care should be taken when generalizing findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2077","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T09:03:48Z","timestamp":1660208628000},"page":"895-905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with Medicaid participation among infants born with birth defects in Texas, 2010\u20132014"],"prefix":"10.1002","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-8069","authenticated-orcid":false,"given":"Justin","family":"Swanson","sequence":"first","affiliation":[{"name":"College of Public Health University of South Florida  Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-2835","authenticated-orcid":false,"given":"Charlie","family":"Shumate","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch Texas Department of State Health Services  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-4155","authenticated-orcid":false,"given":"A. J.","family":"Agopian","sequence":"additional","affiliation":[{"name":"Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura E.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Canfield","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch Texas Department of State Health Services  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0077-6023","authenticated-orcid":false,"given":"Jason L.","family":"Salemi","sequence":"additional","affiliation":[{"name":"College of Public Health University of South Florida  Tampa Florida USA"},{"name":"Department of Obstetrics and Gynecology, Morsani College of Medicine University of South Florida  Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6602a1"},{"volume-title":"Web\u2010based injury statistics query and reporting system (WISQARS)","year":"2003","author":"Centers for Disease Control and Prevention","key":"e_1_2_8_3_1"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"1","article-title":"Update on overall prevalence of major birth defects\u2014Atlanta, Georgia, 1978\u20132005","volume":"57","author":"Centers for Disease Control and Prevention","year":"2008","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.90015"},{"key":"e_1_2_8_6_1","unstructured":"Centers for Medicare & Medicaid Services. (2020).Updated December 2020 applications eligibility and enrollment data.https:\/\/www.medicaid.gov\/medicaid\/national\u2010medicaid\u2010chip\u2010program\u2010information\/medicaid\u2010chip\u2010enrollment\u2010data\/monthly\u2010medicaid\u2010chip\u2010application\u2010eligibility\u2010determination\u2010and\u2010enrollment\u2010reports\u2010data\/index.html"},{"issue":"7","key":"e_1_2_8_7_1","first-page":"1","article-title":"Infant Mortality in the United States, 2018: Data from the period linked birth\/infant death file","volume":"69","author":"Ely D. M.","year":"2020","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2249"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1854"},{"issue":"9","key":"e_1_2_8_10_1","first-page":"1","article-title":"Deaths: Leading causes for 2019","volume":"70","author":"Heron M.","year":"2021","journal-title":"National Vital Statistics Reports"},{"issue":"4","key":"e_1_2_8_11_1","first-page":"1","article-title":"Cause\u2010of\u2010death data from the fetal death file, 2015\u20132017","volume":"69","author":"Hoyert D. L.","year":"2020","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_8_12_1","unstructured":"Mandatory Coverage. (2021).42 C.F.R. \u00a7\u00a7 435.100\u2013435.172.https:\/\/www.ecfr.gov\/current\/title\u201042\/chapter\u2010IV\/subchapter\u2010C\/part\u2010435\/subpart\u2010B\/subject\u2010group\u2010ECFR7ea32cbf5046e69"},{"issue":"2","key":"e_1_2_8_13_1","first-page":"1","article-title":"Births: Final data for 2019","volume":"70","author":"Martin J. 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