Newborn Outcomes among Veterans Utilizing VHA Maternity Benefits, 2016-2020

Background: Public Law (PL) 111-163 Section 206 of the Caregivers and Veteran Omnibus Health Services Act amended the Veterans Health Administration’s (VHA) medical benefits package to include seven days of medical care for newborns delivered by Veterans. We examined the newborn outcomes among a cohort of women Veterans receiving VHA maternity benefits and care coordination. Methods: We conducted a secondary analysis of phone interview data from Veterans enrolled in the COMFORT (Center for Maternal and Infant Outcomes Research in Translation) study 2016-2020. Multivariable regression estimated associations with newborn outcomes (preterm birth; low birthweight). Results: During the study period, 829 infants were born to 811 Veterans. Mothers reported “excellent health” for 94% of infants. Low birth weight (less 5.8 pounds) affected 9%; 11% were preterm births; 42% of infants required follow-up care for non-routine health conditions; 11% were uninsured at 2 months of age. Adverse newborn outcomes were more common for mothers who were older in age, self-identified as non-white in race and/or of Hispanic ethnicity, had a diagnosis of PTSD, or had gestational comorbidities. Conclusions: The current VHA maternity coverage appears to be an effective policy for ensuring the well-being and healthcare coverage for the majority of Veterans’ newborns in the first days of life, thereby reducing risk of inadequate neonatal care. Future research should examine costs associated with extending coverage to 14 days or longer, comparing those to the projected excess costs of neonatal health problems.