Economic costs associated with moderate and late preterm birth: A prospective population-based study

Objective: We sought to determine the economic costs associated with moderate and late preterm birth. Design: An economic study was nested within a prospective cohort study. Sample: Infants born between 32+0 and 36+6 weeks gestation in the East Midlands of England. A sample of infants born at ≥37 weeks’ gestation acted as controls. Methods: Resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, was collected between birth and 24 months corrected age (or death) and valued in GB£, 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs. Results: Of all eligible births, 1,146 (83%) preterm and 1,258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12,037 (£1,114) and £5,823 (£1,232) for children born moderately preterm (32+0 to 33+6 weeks) and late preterm (34+0 to 36+6 weeks), respectively, compared to £2,056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4,657 (bootstrap 95% CI £2,513, £6803; p<0.001). Multivariable regressions revealed that, after controlling for clinical and sociodemographic characteristics, moderate and late preterm birth increased societal costs by £7,583 (£874) and £1,963 (£337), respectively, compared to birth at full term. Conclusions: Moderate and late preterm birth is associated with significantly increased economic costs over the first two years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences.