WASHINGTON-The tiniest premies' disproportionate share of childbirth spending may be less weighty than supposed.
Neonatologist Elaine Barefield of UA Birmingham, extrapolating from a base of 958 premies and controls, says a typical doctor and hospital bill for a surviving baby born at 24 weeks is $145,000, vs. $441 for term births.
But she says that the total tab for the earliest viable babies, those few born at 24 and 25 weeks' gestation, is less than 7% of the $10.2 billion spent annually on professional and hospital care surrounding childbirth.
Dr. Barefield estimates that all premies of 29 weeks or less account for 27% of the total spending, and premies born at 30 weeks through 36 weeks account for 30%. Term births, by far the largest group, account for 43%.
In another study at the Society for Pediatric Research meeting here, Dr. Jonathan Muraskas of Chicago's Loyola University Hospital said survival of 1,372 infants born at 29 weeks' gestation or less rose from 63% to 84% from 1985 to 1994. Survival of the youngest, born at 25 weeks or less, rose from 25% to 64%, he said.
Yet up to 50% of those weighing between 500 and 750 g are discharged with significant disabilities, he says. Topping the list are chronic lung disease, intraventricular hemorrhage, vis-ual impairment, and cerebral palsy. The daily cost of newborn care is $4,000.
UCSF's Mureen Schlueter found that the costs of caring for 127 infants born between 24 and 26 weeks worked out to $203,790 per surviving infant. The 94 surviving premies born from 1990 to 1994 accounted for 8,486 hospital days, she reports.
But the cost for those born at 24 weeks was $326,917 per survivor, vs. $172,552 for those born at 26 weeks. "This emphasizes the importance of prolonging gestation to at least 25 weeks," she says.
WASHINGTON-The tiniest premies' disproportionate share of childbirth spending may be less weighty than supposed.
