Battered by lower birth rates and rising numbers of low-paying Medicaid patients, Pediatrix Medical Group announced Wednesday it was lowering its earning expectations while making ``one of our largest acquisitions ever.''

In a busy day for South Florida's largest publicly traded healthcare company, the Sunrise-based firm that provides physician services said its expectations for the third quarter were now 81 to 83 cents per share. Analysts polled by Thomson Financial had expected 85 cents for the quarter, according to The Associated Press.

Pediatrix also said it closed Tuesday on the purchase of Critical Health Systems of North Carolina, a practice with 61 anesthesiologists and 191 certified registered nurse anesthetists. The company also purchased Maternal-Fetal Group, consisting of three physicians in Nashville. Terms of the deals were not announced.

In a conference call with analysts, executives refused to issue earnings guidance for the fourth quarter or 2009.

One analyst responded that the refusal ''leaves people with a very bad taste in their mouth,'' but the executives said there was too much uncertainty for them to predict earnings.

Investors sent the stock tumbling 11.6 percent, closing at $47.65, down $6.27 for the day.

As he had in the second-quarter conference call, Chief Executive Roger Medel said that births were down at hospitals where Pediatrix ran neonatal units and the company was seeing an increase in Medicaid patients while getting fewer patients with private insurance.

Medicaid, the state-federal health plan for the poor, pays far less than for-profit insurers.

The latest census data, released in August, showed that the number of persons without insurance in the United States dropped to 45.7 million in 2007, but 1.3 million more persons squeezed onto the roles of Medicaid, despite administration efforts to reduce reliance on the program.

The North Carolina operation, in Raleigh, provides anesthesiology services at five hospitals, three out-patient surgery centers and two pain-management centers.

Pediatrix, which has a total stock valuation of about $2.2 billion and now employs almost 1,200 physicians in 32 states, plans to change its name to Mednax in 2009, to reflect its expansion beyond pediatric services.

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