The growing number of babies born prematurely, often to older and more
overweight mothers, is costing the NHS almost £1billion a year more than if
they were born full-term, research shows.
The first study to assess the financial burden of premature birth in England
and Wales concludes that there are nearly £20,000 of additional care costs
associated with the average premature baby. The research, published today in
the American journal Pediatrics, indicates that most of the £939 million in
extra costs are linked to neo-natal care such as incubation, and hospital
readmissions.
The rate of premature births has increased sharply in recent years. In 2006,
7 per cent of all births were preterm — a total of almost 48,000 babies —
rising to 8.6 per cent in 2007.
Factors linked to the increase include the age and weight of mothers, and
the greater use of fertility treatments that raise the chances of a
premature birth. About half of all mothers aged between 25 and 44 are now
overweight or obese, according to latest statistics. Being a teenage mother
or underweight also carries risks.
Babies born early — before 37 weeks — are more susceptible to serious
problems including lung disease, eye and digestive tract conditions and
increased risk of infection. They also account for the majority of intensive
care admissions.
Tommy’s, the baby charity that funded the study, said that it showed the
need for greater research into premature birth and methods for delaying or
preventing it, such as delaying a woman’s contractions.
The study, conducted by Lindsay Mangham and Stavros Petrou of Oxford
University’s Health Economics Research Centre,concluded that delaying
premature births by a single week could save £260m a year, potentially.
Jane Brewin, chief executive of Tommy’s, said that the charity was working
with the Department of Health and other stakeholders to draw up a strategy
to address the problem.
“Given that the UK rate of premature birth is rising, the mammoth cost [of
preterm births] is set to grow even larger. A plan must be developed which
will target medical research resources to reduce premature birth.”
Andrew Shennan, Professor of Obstetrics at King’s College London, said that
the delivery of a baby would never be affected by cost considerations. But
it underlined the need for a greater attention in primary care to
encouraging women wanting to become mothers, particularly those who had
gained weight during a previous pregnancy, to lose weight, he said.
The study was based on a literature review, extensive research of current
clinical practice and unit costs and consultations with leading clinicians.
The information was used to produce a model that assigned a probability and
a cost to possible outcomes associated with premature birth, including the
need for neonatal care, mild disability, moderate disability, severe
disability and death.
The study authors were then able to devise an average patient and associated
cost for each week of prematurity, going back to gestation at 23 weeks. As
well as neonatal healthcare, which made up most of the expense, other costs
such as hospital readmissions, outpatient visits, special education needs
and social services costs were also considered.
The model estimated total cost of all preterm babies born in 2006 over the
first 18 years of their lives, in 2006 prices and with a slight discount.
While the average cost of a child born full-term was estimated at £41,907,
the extra cost for the average premature baby surviving to age 18 was
£22,764. For babies born under 33 weeks and 28 weeks, the additional costs
were £61,509 and £94,190 respectively.
Professor Peter Brocklehurst, director of the National Perinatal
Epidemiology Unit (NPEU), University of Oxford, said: “The extent to which
the costs associated with preterm birth are an economic burden has
previously received little attention.
“These results emphasise the importance of preventing preterm birth. We
propose that more effort is focused on preventing preterm birth in the UK
and that research to prevent premature birth continues to be a strategic
priority.”
The Royal College of Obstetricians and Gynaecologists said: “Lifestyle
factors such as maternal obesity and binge drinking contribute to an
increased risk of prematurity. It is important therefore to develop public
health programmes aimed at preventing preterm birth.”
Andy Cole, chief executive of Bliss, the baby care charity, welcomed the
research, but said that a baby was born needing specialist hospital care in
the UK every six minutes, and these births were often a consequence of
various unavoidable conditions.
“Our children deserve the optimum level of care and support that we can
possibly provide . . . We cannot and should not judge a life by an economic
metric.”
Tommy’s said that as well as the financial cost, the increase in babies born
too early put added emotional strain on families who must deal with the
lifelong consequences of a baby born too soon. While health and social care
unit costs are well documented, costs in other areas such as special needs
education, and costs incurred by families in caring for preterm children,
are less well reported.