Infant Delivery Costs Related to Maternal Smoking: An Update
- 20 July 2011
- journal article
- Published by Oxford University Press (OUP) in Nicotine & Tobacco Research
- Vol. 13 (8), 627-637
- https://doi.org/10.1093/ntr/ntr042
Abstract
Introduction: Adverse maternal and infant health outcomes due to maternal smoking are well known. Previous estimates of health care costs for infants at delivery attributable to maternal smoking were $366 million, $704 per smoker, in 1996 dollars. Changes in antenatal and neonatal care, medical care inflation, and declines in the prevalence of maternal smoking call for an updated analysis. Methods: We used Pregnancy Risk Assessment Monitoring System for 2001/2002 to estimate the association of maternal smoking to Neonatal Intensive Care Unit (NICU) admission and, in turn, the length of stay for infants admitted/not admitted. Models are then used with 2003 natality files to derive predicted expenses as is and “as if” mothers did not smoke. The difference in these predicted expenses is smoking attributable expenses (SAEs). The updated analysis incorporated Hispanic ethnicity as an additional variable, data from 27 as opposed to 13 states, and updated (2004) NICU costs per night. Results: In contrast to earlier work, we find no significant association of maternal smoking and NICU admission but rather, a positive effect on the length of stay of exposed infants once admitted to the NICU. SAEs were estimated at $122 million (CI = −$29m to $285m) nationally and $279 (CI = −$76 to $653) per maternal smoker in 2004 dollars. Conclusions: Declines in maternal smoking prevalence between the mid-1990s and 2003 combined with a weaker relationship of maternal smoking to NICU admission offset medical care inflation such that infants’ SAEs declined. Yet, these are significant in magnitude, incurred immediately and highly preventable.This publication has 27 references indexed in Scilit:
- Maternal Tobacco Use and Shorter Newborn Nursery StaysAmerican Journal of Preventive Medicine, 2009
- What's new in Nicotine & Tobacco Research?Nicotine & Tobacco Research, 2008
- Medicaid reimbursement for prenatal smoking intervention influences quitting and cessationTobacco Control, 2006
- The Effect of Medicaid Payment Generosity on Access and Use among BeneficiariesHealth Services Research, 2005
- Birth and first-year costs for mothers and infants attributable to maternal smokingNicotine & Tobacco Research, 2001
- Effect of Surfactant on Morbidity, Mortality, and Resource Use in Newborn Infants Weighing 500 to 1500 gThe New England Journal of Medicine, 1994
- Cost effects of surfactant therapy for neonatal respiratory distress syndromeThe Journal of Pediatrics, 1993
- Bed sharing, smoking, and alcohol in the sudden infant death syndrome. New Zealand Cot Death Study Group.BMJ, 1993
- Pre‐pregnancy risk factors of small‐for‐gestational age births among parous women in ScandinaviaActa Obstetricia et Gynecologica Scandinavica, 1993
- The central role of the propensity score in observational studies for causal effectsBiometrika, 1983