Study of the costs and morbidities of late-preterm birth
- 1Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
- 2Research Center, CHU Sainte Justine, Montreal, Quebec, Canada
- 3Ecole Nationale de la Statistique et de l’Analyse de l’Information, Department of Statistics, Rennes, France
- Correspondence to Dr Anick Bérard, Université de Montréal, CHU Sainte Justine Research Center, 3175, Côte-Sainte-Catherine, Montreal, Quebec, Canada H3T 1C5;
Contributors Dr Anick Bérard: conception and design, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. Ms Magali Le Tiec: conception and design, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. Dr Mary A De Vera: interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
- Received 2 September 2011
- Accepted 20 December 2011
Objective To compare late-preterm infants (33–36 weeks) with term infants (≥37 weeks) on incidence of morbidities in the first 3 years of life and healthcare costs during the first 2 years of life and third year of life.
Methods Administrative health records of live infants born between January 1, 1997, and December 31, 2000 with 3 years follow-up data (N=35733) were linked. First, diagnoses of morbidities were compared between late-preterm and term infants using Cox's proportional hazards models. Healthcare costs expressed as mean total costs and cost ratios, accrued following initial hospital discharge after birth, were also examined.
Results The three most common reasons for hospitalisation in late-preterm and term infants were acute bronchitis, otitis media and pneumonia. The most frequent reasons for physician visits included acute upper respiratory infections, otitis media and bronchiolitis. The highest HR were detected for chronic bronchitis 1.64 (1.13–2.39), hearing loss 1.56 (1.14–2.15) and bacterial diseases 1.28 (1.09–1.49). The mean total cost for late-preterm infants during the first 2 years of life was $2568 CAD compared with $1285 CAD for term infants, cost ratio =1.99 (95% CI 1.90 to 2.09). In the third year of life, the cost ratio reduced to 1.46 (95% CI 1.39 to 1.54).
Conclusions Late-preterm infants are at higher risk of specific morbidities compared with term infants. Their mean total costs fall from almost double that of term infants during the first 2 years of life, to just 46% greater in the third year of life.
Funding This study was supported by Les Fonds de la Recherche en Santé du Québec (FRSQ), the Réseau Québécois de recherche sur l’usage des médicaments (RQRUM) and the Réseau FRSQ for the well-being of children.
Competing interests None.
Ethics approval CHU Sainte Justine Research Ethics Board and Commission for Access to Information of Quebec.
Provenance and peer review Not commissioned; externally peer reviewed.