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Prenatal and post-natal cost of small for gestational age infants: a national study
Alicia Marzouk1,2, Antoine Filipovic-Pierucci3, Olivier Baud4,5
1URC ECO, Hôtel Dieu 1 Place du Parvis de Notre Dame, 75004, Paris, France. alicia.marzouk@urc-eco.fr.
Insights
Small for gestational age (SGA) infants incur higher healthcare costs than appropriate for gestational age (AGA) infants. This independent factor increases maternal and infant hospital expenses through the first year of life.
Area of Science:
- Neonatal care
- Perinatal health economics
- Public health
Background:
- Small for gestational age (SGA) infants face increased risks for preterm birth complications and adverse perinatal outcomes.
- These outcomes are partly attributed to premature birth associated with SGA status.
- Evaluating the economic impact of SGA is crucial for understanding healthcare resource allocation.
Purpose of the Study:
- To assess the healthcare costs associated with small for gestational age (SGA) infants compared to appropriate for gestational age (AGA) infants in France.
- To differentiate the cost contributions of prematurity versus fetal growth restriction in SGA infants.
- To analyze costs from pregnancy through the infant's first year of life.
Main Methods:
- A cross-sectional, population-based study utilizing French national hospital discharge data (2011).
- SGA infants defined as birth weight below the 10th percentile; AGA infants between the 25th and 75th percentile.
- Hospital costs calculated from the hospital perspective for mothers and infants using Diagnostic Related Groups and national cost data.
Main Results:
- In 2011, 10.9% of births were SGA (84,688 infants).
- SGA infants incurred an average of €2,783 higher costs than AGA infants, adjusted for gestational age.
- Maternal and infant hospital costs for SGA accounted for 23% of total delivery costs, driven by higher complication rates, readmissions, and longer hospital stays.
Conclusions:
- Small for gestational age (SGA) is an independent factor contributing to increased 1-year hospital costs for both mothers and infants.
- Targeted interventions for SGA infants may reduce long-term healthcare expenditures.
- Understanding the economic burden of SGA is essential for healthcare policy and planning.
Background:
Small for gestational age (SGA) infants are at increased risk for preterm birth morbidities as well as a range of adverse perinatal outcomes that result in part from associated premature birth. We sought to evaluate the costs of SGA versus appropriate for gestational age (AGA) infants in France from pregnancy through the first year of life and separate the contributions of prematurity from the contribution of foetal growth on costs.
Methods:
This is a cross-sectional population-based study using national hospital discharge data from French public and private hospitals. SGA infants were defined as newborns with a birth weight below the 10th percentile of French intrauterine growth curves adjusted for foetal sex. AGA infants were defined as newborns with a birth weight between the 25th and the 75th. All births were selected between January 1st, 2011 and December 31st, 2011. Costs were calculated from the hospital perspective for both mothers and children using their diagnostic related group and the French national cost study. Hospital outcomes were extracted from the database and compared by gestational age and mode of delivery.
Results:
Of 777,720 total births in 2011, 84,688 SGA births (10.9%) and 395,760 AGA births (50.8%) were identified. After adjustment for gestational age, the cost for an SGA infant was €2,783 higher than for an AGA infant. The total maternal and infant hospital cost of SGA in France was estimated at 23% the total cost for deliveries. The high cost is explained by higher complication rates, more frequent hospital readmissions and longer lengths of stay.
Conclusions:
Being small for gestational age is an independent contributor to 1-year hospital costs for both mothers and infants.
