The economic consequences of preterm birth during the first 10 years of life

Objective: To examine the association between gestational age at the time of birth and long-term use and cost of hospital inpatient services. Design: Multi-level modelling of the hospital service utilisation and cost profile of each child born in hospital during 1978-1988 in two areas covered by the Oxford Record Linkage Study. Setting: Oxfordshire and West Berkshire. Population: 117,212 children divided into four subgroups by gestational age at birth: <28 weeks, 28-31 weeks, 32-36 weeks, 37 weeks or greater. Main outcome measures: Number and duration of hospital admissions during the first 10 years of life. Costs, expressed in £ sterling and valued at 1998-1999 prices, of hospital inpatient services. Results: The cumulative cost of hospital inpatient admissions incurred during the first 10 years of life, including the initial birth admission, averaged £17,819.94 [£22,322.87] for children born at <28 weeks gestation, £17,751.00 [£19,055.53] for children born at 28-31 weeks gestation, £5,376.39 [£7,393.78] for children born at 32-36 weeks gestation, and £1,658.63 [£3,409.14] for children born at 37 weeks gestation or greater. The adjusted number of hospital inpatient admissions, inpatient days and costs, respectively, over the first 10 years of life was 130%, 77% and 443% higher for children born at <28 weeks gestation than for children born at term. Conclusion: The adverse sequelae of preterm birth are likely to have considerable long-term economic consequences for the health services and for society as a whole. © RCOG 2005.