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Premature births cost society billions, University of Utah economists say

By Ashley Imlay, KSL | Posted - Nov 10th, 2019 @ 7:35am



SALT LAKE CITY — Preterm birth costs show that providing health care and early intervention to underserved mothers can save society billions of dollars, University of Utah economists say.

According to the March of Dimes report, 1 in 10 babies in the U.S. was born premature, or before 37 weeks, in 2016. Those early births cost society $25.2 billion, or $64,815 per preterm birth — costs including medical services, early intervention and special education services, among other indirect costs.

“For the most part, what these cost figures do, is they tabulate in economic terms some of the consequences of avoidable outcomes — potentially avoidable outcomes — if we intervene with better prenatal care, better, more attentive maternal care,” explained Norman Waitzman, U. economics professor and co-author of the analysis.

Utah’s statistics are a little better than the national average, with 9.4% of infants in 2016 born preterm. But the state still received a “C+” ranking from March of Dimes, along with other states with between 9.3% and 9.6% preterm rates. By comparison, only Oregon received an “A” grade, with equal or less than 7.7% preterm births, according to the report.

Washington and Utah counties saw the lowest preterm birth rates, while the rest of the counties saw rates 9.3% and higher.

In 2016, preterm births cost $273 million in Utah, or $56,339 per birth.

Waitzman says that greater than one-third of the costs come from those born extremely preterm, at earlier than 28 weeks.

“They need to be given very important, critical care in the perinatal period. And they stay in the hospital oftentimes for three months or more, at that point. And that has a lot of resources that are devoted,” Waitzman explained.

And as many as 50% of those born extremely preterm have some form of developmental disability like cerebral palsy, or cognitive disabilities, he said.

While the costs and outcomes of preterm births affect societies as a whole, according to the report, those hit hardest tend to be minority groups. In Utah, the average rate of preterm births among Asian and Pacific Islander populations was 11.1%, nearly 2% higher than among white communities. The rates were also higher among African Americans, Latinos and Native Americans, the analysis states.

The March of Dimes in its report recommends Medicaid coverage extension to all women to at least one year after giving birth; enhanced reimbursements to providers who offer group prenatal care; and the establishment of maternal mortality review committees.

Although we don’t know everything that causes preterm births, Waitzman said, the analysis emphasizes the need to address society risks including lack of health care.

“You know, we have not (fully) expanded Medicaid in the state. I think that, basically, among the most vulnerable populations, we need to be very attentive, in terms of providing good health care,” Waitzman said.

However, he acknowledged that “this is not going to solve the problem, because that’s only one component. Health care is just one component, but the fact that we basically don’t do better in that regard, it is a concern, I think, that the state ought to be attentive to. Because you’re paying in the back end, in this regard.”

And when mothers aren’t covered by insurance when they give birth preterm, “The whole society bears the cost, the whole community,” Waitzman said.

Correction: A previous version incorrectly stated extremely preterm births account for two-thirds of the societal costs of preterm births. They actually account for one-third of the costs.

Ashley Imlay

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