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The cost of prematurity: quantification by gestational age and birth weight.
Obstet Gynecol 2003; 102(3):488-92OG

Abstract

OBJECTIVE

To determine gestational age- and birth weight-related pregnancy outcomes and resource use associated with prematurity in surviving neonates.

METHODS

A data set linking birth certificates with maternal and newborn hospital discharge records from hospitals in California (from January 1, 1996, to December 31, 1996) was examined for all singleton deliveries by gestational age (weekly, from 25 to 38 weeks) and birth weight (by 250-g increments from 500 to 3000 or more g). Records were examined for respiratory distress syndrome (RDS), use of mechanical ventilation, length of hospital stay in days, and hospital costs.

RESULTS

As expected, RDS, ventilation, length of hospital stay, and costs per case decreased exponentially with increasing gestational age and birth weight. Specifically, neonatal hospital costs averaged 202,700 dollars for a delivery at 25 weeks, decreasing to 2600 dollars for a 36-week newborn and 1100 dollars for a 38-week newborn. Neonatal costs were 224,400 dollars for a newborn at 500-700 g, decreasing to 4300 dollars for a newborn at 2250-2500 g and 1000 dollars for a birth weight greater than 3000 g. For each gestational age group from 25 to 36 weeks, total neonatal costs were similar, despite increasing case numbers with advancing gestational age. Neonatal RDS and need for ventilation were significant at 7.4% and 6.3%, respectively, at 34 weeks' gestation. Significant "excess" costs were found for births between 34 and 37 weeks' gestational age when compared with births at 38 weeks.

CONCLUSION

Prematurity, whether examined by gestational age or birth weight, is associated with significant neonatal hospital costs, all of which decrease exponentially with advancing gestational age. Because total costs for each gestational age group from 25 to 36 weeks were roughly the same (38,000,000 dollars), opportunity for intervention to prevent preterm delivery and decrease costs is potentially available at all preterm gestational ages.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of California at Davis, California, USA. wmgilbert@ucdavis.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12962929

Citation

Gilbert, William M., et al. "The Cost of Prematurity: Quantification By Gestational Age and Birth Weight." Obstetrics and Gynecology, vol. 102, no. 3, 2003, pp. 488-92.
Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003;102(3):488-92.
Gilbert, W. M., Nesbitt, T. S., & Danielsen, B. (2003). The cost of prematurity: quantification by gestational age and birth weight. Obstetrics and Gynecology, 102(3), pp. 488-92.
Gilbert WM, Nesbitt TS, Danielsen B. The Cost of Prematurity: Quantification By Gestational Age and Birth Weight. Obstet Gynecol. 2003;102(3):488-92. PubMed PMID: 12962929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cost of prematurity: quantification by gestational age and birth weight. AU - Gilbert,William M, AU - Nesbitt,Thomas S, AU - Danielsen,Beate, PY - 2003/9/10/pubmed PY - 2003/10/16/medline PY - 2003/9/10/entrez SP - 488 EP - 92 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 102 IS - 3 N2 - OBJECTIVE: To determine gestational age- and birth weight-related pregnancy outcomes and resource use associated with prematurity in surviving neonates. METHODS: A data set linking birth certificates with maternal and newborn hospital discharge records from hospitals in California (from January 1, 1996, to December 31, 1996) was examined for all singleton deliveries by gestational age (weekly, from 25 to 38 weeks) and birth weight (by 250-g increments from 500 to 3000 or more g). Records were examined for respiratory distress syndrome (RDS), use of mechanical ventilation, length of hospital stay in days, and hospital costs. RESULTS: As expected, RDS, ventilation, length of hospital stay, and costs per case decreased exponentially with increasing gestational age and birth weight. Specifically, neonatal hospital costs averaged 202,700 dollars for a delivery at 25 weeks, decreasing to 2600 dollars for a 36-week newborn and 1100 dollars for a 38-week newborn. Neonatal costs were 224,400 dollars for a newborn at 500-700 g, decreasing to 4300 dollars for a newborn at 2250-2500 g and 1000 dollars for a birth weight greater than 3000 g. For each gestational age group from 25 to 36 weeks, total neonatal costs were similar, despite increasing case numbers with advancing gestational age. Neonatal RDS and need for ventilation were significant at 7.4% and 6.3%, respectively, at 34 weeks' gestation. Significant "excess" costs were found for births between 34 and 37 weeks' gestational age when compared with births at 38 weeks. CONCLUSION: Prematurity, whether examined by gestational age or birth weight, is associated with significant neonatal hospital costs, all of which decrease exponentially with advancing gestational age. Because total costs for each gestational age group from 25 to 36 weeks were roughly the same (38,000,000 dollars), opportunity for intervention to prevent preterm delivery and decrease costs is potentially available at all preterm gestational ages. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/12962929/The_cost_of_prematurity:_quantification_by_gestational_age_and_birth_weight_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0029784403006173 DB - PRIME DP - Unbound Medicine ER -