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Costs of hospitalization in preterm infants: impact of antenatal steroid therapy Please cite this article as: Ogata JF, Fonseca MC, Miyoshi MH, Almeida MF, Guinsburg R. Costs of hospitalization in preterm infants: impact of antenatal steroid therapy. J Pediatr (Rio J). 2016;92:24-31. ☆☆ ☆☆ Discipline of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

ABSTRACT

OBJECTIVE:

To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS).

METHOD:

Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique.

RESULTS:

Of 220 patients that met the inclusion criteria, 211 (96%) charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU). In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p = 0.008). The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p = 0.008) and a 49% reduction of NICU length of stay (p = 0.011).

CONCLUSION:

ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age.

Keywords:
Preterm infant; Costs and cost analysis; Hospitalization; Glucocorticoids

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