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. 2019 Mar 1;19(1):69.
doi: 10.1186/s12887-019-1424-8.

Impact of birthweight on health-care utilization during early childhood - a birth cohort study

Mario Rüdiger  1 , Luise Heinrich  2 , Katrin Arnold  2 , Diana Druschke  2 , Jörg Reichert  3 , Jochen Schmitt  2
Affiliations

Impact of birthweight on health-care utilization during early childhood - a birth cohort study

Mario Rüdiger et al. BMC Pediatr. .

Abstract

Background: Comprehensive data are needed to evaluate the burden of low birthweight. Analysis of routine data on health-care utilization during early childhood were used to test the hypothesis that infants with low birthweight have (i) increased inpatient health-care utilization, (ii) higher hospital costs and (iii) different morbidity pattern in early childhood when compared with normal birthweight infants.

Methods: Children born between 2007 and 2013 that were insured at birth with the statutory health insurance AOK PLUS were included (N = 118,166, equaling 49% of the Saxon newborns) and classified into very low (< 1500 g, VLBW), low (1500-2499 g, LBW) birthweight and reference group (> 2500 g). Outcomes were: inpatient health-care utilization quantified by number and length of hospital stays; costs of hospitalizations including medication; reasons of hospitalizations for each year of life (YOL).

Results: 72, 38 and 22% of VLBW-, LBW- and reference group were hospitalized after perinatal period within the first YOL with a more than 5-fold increased risk in VLBW to be hospitalized for hemangioma, convulsions, hydrocephalus, hernia and respiratory problems. Median (IQR) cumulative cost of inpatient care during the first four YOLs was 2953 (1213-7885), 1331 (0-3451) and 0 (0-2062) Euro for respective groups. Inpatient early childhood health-care utilization (after first YOL) was higher in VLBW compared to healthy, normal birth weight infants (RR 3.92 [95%-CI 3.63, 4.23]), residents of rural areas (RR 1.37 [95%-CI 1.35, 1.40]) and in boys (RR 1.31 [95%-CI 1.29, 1.33]).

Conclusion: This large population-based birth-cohort study indicates a high clinical and economic burden of low birthweight which is not restricted to the first year of life.

Keywords: Birth cohort; Birthweight; Burden of disease; Cost; Epidemiology; Health care; Preterm birth.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the responsible ethics committee of the Technische Universität Dresden (EK 67022014) and the Saxon Data Protection Commissioner (2–7410-74/1). The study was performed in accordance with the declaration of Helsinki. Since the study used health insurance data, no individual consent of participation was required.

Consent for publication

Not applicable.

Competing interests

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Number of hospital stays during 1st year following perinatal hospitalization by length of perinatal hospitalization and birthweight. Shown are the relative percentages of perinatally hospitalized VLBW-(n = 892), LBW-(n = 3891) and reference-infants (n = 14,501) with 1(blue), 2(red), 3(green) or more than 3(orange) hospitalizations during the first year after perinatal hospitalization (VLBW: χ2 = 55, LBW: χ2 = 286, NBW: χ2 = 777, all p-values < 0.001)
Fig. 2
Fig. 2
Number of hospital stays excluding perinatal hospitalization by YOL and birthweight. Shown are the relative percentages of VLBW-, LBW- and reference-infants with 1(blue), 2(red), 3(green) or more than 3(orange) hospitalizations in the respective year of life (YOL) excluding perinatal hospitalization (number of infants analysed per YOL are shown in supplement)
See this image and copyright information in PMC

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