Pregnancy and infants healthier with Omega-3 supplementation - many studies 4X less stillbirth with Omega-3
Extra $750 for stillbirth, but less cost for child development
Hospital costs associated with stillbirth delivery.
Matern Child Health J. 2013 Dec;17(10):1835-41. doi: 10.1007/s10995-012-1203-8.
Gold KJ1, Sen A, Xu X.
1Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104-1213, USA, ktgold@umich.edu.
Fetal deaths account for nearly one percent of all births in the United States. The cost of hospital care associated with fetal deaths may be substantial. However, there is very limited data on the economic burden of fetal death. We conducted a retrospective medical chart review of stillbirths at three large hospitals in Michigan over a ten-year period and identified medical complications, hospital costs, and length of stay for these deliveries. Mothers with stillbirth were matched with mothers of the same age who delivered a live-born infant at the same hospital during the same year. Our final sample was comprised of 533 stillbirths and 1,053 matched live births. Average hospital cost for stillbirth was $7,495 (±7,015) and the average length of stay was 2.8 days (±2.8). Having a serious maternal medical complication was associated with higher costs and longer length of stay among women with stillbirth. Early stillbirths between 20 and 28 weeks gestational age, epidural/spinal/general anesthesia, and cesarean delivery were also associated with longer length of stay. Average hospital costs for women with stillbirth were more than $750 higher than women with live births but length of stay was not significantly different between the two. This study suggests that stillbirths were associated with substantial maternal hospital costs. Future research examining the economic impact of stillbirths beyond labor and delivery such as increased costs associated with additional testing and care in subsequent pregnancies will help better understand the overall economic impact of stillbirths.
PMID: 23242573
Stillbirth costs and subsequent pregnancy costs in England– 2013
A structured review and exploration of the healthcare costs associated with stillbirth and a subsequent pregnancy in England and Wales
BMC Pregnancy and Childbirth 2013, 13:236 doi:10.1186/1471-2393-13-236
Hema Mistry1, Alexander E P Heazell2, Oluwaseyi Vincent3 and Tracy Roberts1 Tracy Roberts t.e.roberts@bham.ac.uk
1 Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
2 Manchester Academic Health Science Centre, St Mary’s Hospital, Oxford Road, Manchester M13 9WL, UK
3 York Health Economics Consortium, University of York, York YO10 5NH, UK
Background: In contrast to other pregnancy complications the economic impact of stillbirth is poorly understood. We aimed to carry out a preliminary exploration of the healthcare costs of stillbirth from the time of pregnancy loss and the period afterwards; also to explore and include the impact of a previous stillbirth on the healthcare costs of the next pregnancy.
Methods: A structured review of the literature including cost studies and description of costs to health-care providers for care provided at the time of stillbirth and in a subsequent pregnancy. Costs in a subsequent pregnancy were compared in three alternative models of care for multiparous women developed from national guidelines and expert opinion: i) “low risk” women who had a live birth, ii) “high risk” women who had a live birth and iii) women with a previous stillbirth.
Results: The costs to the National Health Service (NHS) for investigation immediately following stillbirth ranged from £1,242 (core recommended investigations) to £1,804 (comprehensive investigation). The costs in the next pregnancy following a stillbirth ranged from
- £2,147 (low-risk woman with a previous healthy child) to
- £3,751 (Woman with a previous stillbirth6of unknown cause).
The cost in the next pregnancy following a stillbirth due to a known recurrent or an unknown cause is almost __£500_- greater than the pregnancy following a stillbirth due to a known non-recurrent cause.
Conclusions: The study has highlighted the paucity of evidence regarding economic issues surrounding stillbirth. Women who have experienced a previous stillbirth are likely to utilise more health care services in their next pregnancy particularly where no cause is found. Every effort should be made to determine the cause of stillbirth to reduce the overall cost to the NHS. The cost associated with identifying the cause of stillbirth could offset the costs of care in the next pregnancy. Future research should concentrate on robust studies looking into the wider economic impact of stillbirth.
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Stillbirth NHS
- Eleven babies are stillborn every day in the UK, making it 15 times more common than cot death
Increase in stillbirth rate by 13% (2000 - 2010) – May 2013
Determinants of increases in stillbirth rates from 2000 to 2010.
CMAJ. 2013 May 14;185(8):E345-51. doi: 10.1503/cmaj.121372. Epub 2013 Apr 8.
Joseph KS1, Kinniburgh B, Hutcheon JA, Mehrabadi A, Basso M, Davies C, Lee L.
1Perinatal Services BC, Vancouver, BC. kjoseph@cw.bc.ca
BACKGROUND: After decades of decline, stillbirth rates have increased in several industrialized countries in recent years. We examined data from the province of British Columbia, Canada, in an attempt to explain this unexpected phenomenon.
METHODS: We carried out a retrospective population-based cohort study of all births in British Columbia from 2000 to 2010. Outcomes of interest included overall stillbirth rates, birth weight-and gestational age-specific stillbirth rates, rates of spontaneous stillbirths (excluding pregnancy terminations that satisfied the definition of stillbirth [fetal death with a birth weight ≥ 500 g or gestational age at delivery ≥ 20 wk], hereafter referred to as "pregnancy terminations") and rates of congenital anomalies among live-born infants. We used logistic regression to adjust for changes in maternal age, parity, weight before pregnancy and multiple births.
RESULTS: Overall, stillbirth rates increased by 31% (95% confidence interval [CI] 13% to 50%), from 8.08 per 1000 total births in 2000 to 10.55 per 1000 in 2010. The rate of stillbirths with a birth weight of less than 500 g increased significantly (p(trend) = 0.03), whereas the rate of stillbirths with a birth weight of 1000 g or more decreased significantly (p(trend) = 0.009). The rate of spontaneous stillbirths decreased nonsignificantly by 16%, from 5.7 per 1000 total births in 2000 to 4.8 per 1000 in 2010. There was a significant decline of 30% (95% CI 6% to 47%) in the rate of spontaneous stillbirth with a birth weight of 1000 g or more between 2000 and 2010; adjustment for maternal factors did not appreciably change this temporal effect. The prevalence of congenital anomalies among live-born infants decreased significantly, from 5.21 per 100 live births during the first 3 years (2000-02) to 4.77 per 100 during the final 3 years (2008-10).
INTERPRETATION: Increases in pregnancy terminations were responsible for the increases observed in stillbirth rates and were associated with declines in the prevalence of congenital anomalies among live-born infants.
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