Cost differences between low birthweight attributable to smoking and low birthweight for all causes
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Published on: August 25, 2014
C Q Li1, R A Windsor, M Hassan
1Office of Educational Research and Development, School of Medicine, University of Alabama at Birmingham.
Insights
Maternal smoking significantly increases low birthweight (LBW) costs. However, LBW infants born due to smoking have lower associated birth costs than average LBW infants, highlighting severity differences.
Area of Science:
- Public Health
- Health Economics
- Perinatal Medicine
Background:
- Low birthweight (<2,500g) is a key predictor of infant mortality.
- The clinical impact and economic burden of low birthweight vary by severity.
- Maternal smoking disproportionately affects moderate low birthweight (1,500-2,499g) compared to very low birthweight (<1,500g).
Purpose of the Study:
- To estimate the economic costs associated with low birthweight attributable to maternal smoking.
- To compare these costs with the average costs of low birthweight from all causes.
- To inform economic analyses of smoking cessation programs for pregnant women.
Main Methods:
- Population-attributable risk was used to quantify smoking-attributable low birthweight.
- Healthcare costs were analyzed across different birthweight categories.
- Cost differences between smoking-attributable and all-cause low birthweight were determined.
Main Results:
- Net incremental costs for smoking-attributable low birthweight ranged from $4,256 to $8,640.
- Average costs for all-cause low birthweight ranged from $5,213 to $10,306.
- Cost differences between the two groups reached up to 18%.
Conclusions:
- Low birthweight resulting from maternal smoking incurs lower initial healthcare costs compared to low birthweight from all causes.
- This cost disparity is primarily due to differences in birthweight severity.
- Findings have implications for evaluating the cost-effectiveness of smoking cessation interventions during pregnancy.
Background:
Low birthweight (< 2,500 g) is one of the major predictors of infant mortality. The clinical salience of low birthweight depends on its severity. The impact of smoking on low birthweight is greater in the 1,500-2,499-gm category than below 1,500 gm. This has an important implication for economic analyses of smoking cessation programs for pregnant women. Because health care cost is closely associated with birthweight, the cost of low birthweight attributable to smoking may be different than the average cost of low birthweight for all causes. Little is known about such cost differences.
Methods:
The population-attributable risk was used to estimate the number and percentage of low-birthweight infants due to maternal smoking. Costs by birthweight groups were used to determine cost differences between low birthweight due to smoking and for all causes.
Results:
The net incremental costs per low birthweight due to smoking range from $4,256 to $8,640 compared to the costs of $5,213 to $10,306 per low birthweight by all causes. The cost differences may be up to 18%.
Conclusion:
Considerably lower costs at birth were found in low birthweight due to smoking than for all causes. The cost difference was attributable to the difference in the severity of low birthweight.
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