Background: Administrative healthcare claims databases are used in drug safety research but are limited for investigating the impacts of prenatal exposures on child outcomes without mother-infant pair identification.
Objective: We developed a mother-infant linkage algorithm that builds on other linkage approaches and applied and evaluated it in two, large US commercially insured populations.
Study Design: We used two US commercial health insurance claims databases covering 2000 to 2021. Mother-infant links were constructed where persons of female sex 12-55 years of age with a pregnancy ending in live birth were associated with a person who was 0 years of age at database entry, who share a common insurance plan ID, had overlapping observation time, and whose date of birth was within ±60-days of the mother’s pregnancy episode end date. We compared the characteristics of linked vs non-linked mothers and linked vs non-linked infants to assess similarity.
Results: The algorithm linked 3,477,960 mothers to 4,160,284 infants in the two databases. Linked mothers and linked infants comprised 73.6% of all mothers and 49.1% of all-infants, respectively. 94.9% of linked infants dates of birth were within 4 weeks of the associated mother’s pregnancy episode end dates. Linked mothers were older, had longer pregnancy episodes, and had greater post-pregnancy observation time than non-linked mothers. Linked infants had less observation time and greater healthcare utilization than non-linked infants. All other linked vs non-linked characteristics were similar in mothers and infants.
Conclusion: We applied a novel mother-infant linkage algorithm to two US commercial healthcare claims databases and achieved a high linkage proportion and demonstrated that linked and non-linked mother and infant cohorts were similar. This enables large-scale research on exposures during pregnancy and pediatric outcomes with relevance to drug safety. Linked vs non-linked population differences may be partially attributable to shared healthcare billing practices within insurance plan IDs among linked mothers and infants.
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