Maternal smoking during pregnancy and expenditures on neonatal health care

Area of Science:

• Public Health
• Neonatal Medicine
• Health Economics

Background:

• Cigarette smoking during pregnancy is a significant risk factor for low birth weight.
• Low birth weight is a major predictor of neonatal morbidity, mortality, and increased healthcare utilization.
• Neonatal intensive care is resource-intensive, particularly for low-birth-weight infants.

Purpose of the Study:

• To estimate the economic burden of neonatal care attributable to maternal smoking during pregnancy.
• To quantify the impact of maternal smoking on low-birth-weight incidence and neonatal intensive care unit admissions.
• To determine the association between maternal smoking and the cost of neonatal care.

Main Methods:

• Utilized 1983 U.S. data to link maternal smoking prevalence with low-birth-weight incidence.
• Calculated the number of low-birth-weight births and neonatal intensive care unit admissions attributed to maternal smoking.
• Estimated the excess expenditures on neonatal care for infants born to smokers compared to nonsmokers.

Main Results:

• Maternal smoking was associated with 35,816 low-birth-weight births (14.5% of total) in 1983.
• Approximately 14,977 neonatal intensive care unit admissions (6.6% of total) were linked to maternal smoking.
• These smoking-attributable admissions incurred an estimated $272 million in costs, representing 8.5% of national neonatal intensive care expenditures.
• The average cost of neonatal care was $288 higher for infants of smokers.

Conclusions:

• Maternal smoking during pregnancy imposes a substantial financial burden on neonatal healthcare systems.
• Reducing smoking rates among pregnant individuals could lead to significant savings in neonatal intensive care costs.
• Public health interventions targeting smoking cessation in pregnant women are crucial for improving neonatal outcomes and reducing healthcare expenditures.