Complex Newborns

Facts & Figures

  • There were more than 4,265,996 million births in 2006, a 3 percent increase over 2005. (National Center for Health Statistics, Births: Preliminary Data for 2006)
  • The preterm birth rate rose slightly from 12.7 percent to 12.8 percent for 2005-2006. (National Center for Health Statistics, Births: Preliminary Data for 2006)
  • More than 546,047 infants are born prematurely each year. (National Center for Health Statistics, Births: Preliminary Data for 2006)
  • The percentage of infants delivered at less than 37 weeks of gestation has risen by 21 percent since 1990. (National Center for Health Statistics, Births: Preliminary Data for 2006)
  • The percentage of infants delivered at less than 34 weeks gestation rose slightly to 3.66 percent (National Center for Health Statistics, Births: Preliminary Data for 2006)
  • The percentage of infants born low birthweight has increased more than 20 percent since the mid-1980's, and is currently 8.3 percent of all births. The highest level reported since 1968.(National Center for Health Statistics, Births: Preliminary Data for 2006)
  • Almost two-thirds of all childhood hospital stays are for newborns and neonates (babies up to 30 days old); the vast majority of these stays (nearly 95 percent) are for the birth of infants in the hospital. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • Children younger than 1 year comprise only 1 percent of the U.S. population, but they account for nearly 13 percent of all hospital stays. The vast majority of these stays are newborn infants. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • Five of the top 10 most common diagnoses for neonates are for either respiratory problems or infections. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • The most common neonatal conditions that require extension of the newborn hospital stay or return to the hospital are conditions associated with bilirubin metabolism (hemolytic jaundice), prematurity (including respiratory distress), respiratory problems, infections, and birth defects. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • Three of the top 10 diagnoses with the longest length of stay are conditions originating in the newborn period: prematurity, respiratory distress, and cardiac and circulatory birth defects. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • The average length of stay for a newborn with some type of complication is nearly 7 days — this is nearly 5 days longer than for newborns without complications. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • Premature babies were up to twice as likely to survive when treated at a busy, advanced-care center (more than 100 preemies per year) instead of one of the many community hospitals that have opened NICUs in recent years. Less than one quarter of very-low-birth-weight deliveries occurred in facilities with NICUs that offered a high level of care and had a high volume, but 92% of very-low-birth-weight deliveries occurred in urban areas with more than 100 such deliveries. (Phibbs, Cairan S. et al, Level and Volume of Neonatal Intensive Care and Mortality in Very Low-Birth-Weight Infants, New England Journal of Medicine, May 24, 2007)
  • Increased risk of death when using less experienced NICUs ranged from 119% to 272%. (Phibbs, Cairan S. et al, Level and Volume of Neonatal Intensive Care and Mortality in Very Low-Birth-Weight Infants, New England Journal of Medicine, May 24, 2007)
  • The incidence of multiple births has increased 88 percent for twin births and 43 percent for triplets+ births from 1980 to 2003. (National Center for Health Statistics, 2005)
  • Multiple infants, resulting from assisted reproductive technology, were born to 35.6 percent of women less than 35 years of age, 30.9 percent of women 35 to 37 years old, 25.1 percent of women 38 to 40 years old, and 16.1 percent of women 41 to 42 years old. (CDC, Division of Reproductive Health, ART Report: 2005)
  • The twin birth rate was unchanged from 2004, 32.2 twins per 1,000 births, another record high. The twinning rate has climbed 42 percent since 1990 and 70 percent since 1980. There is a downward trend in the rate of triplet and higher order multiple births, observed since 1999. The 2005 level is 16 percent lower than the 1998 high. (National Center for Health Statistics, Births: Final Data for 2005)
  • In multiple births, 60 percent of twins, 90 percent of triplets, and virtually all other higher order multiples are born preterm. (March of Dimes 2003)
  • In 2004, the average birthweight of twins was nearly 1,000 grams lower than that of singletons (2,333 grams, or 5 lb 2 oz, compared with 3,316 grams, or 7 lb 5 oz); the average triplet/+ weighed about one-half the average singleton (1,700 grams, or 3 lb 12 oz). (National Center for Health Statistics, Births: Final Data for 2004)
  • In 2005, the annual societal economic cost (medical, educational, and lost productivity) associated with preterm birth in the United States was at least $26.2 billion. Average first year medical costs were about 10 times greater for preterm than term infants. (March of Dimes)
  • In 2003, hospital charges for all infants totaled $37.7 billion. Nearly half of these charges - $18.1 billion – was for infants with a diagnosis of prematurity or low birthweight.
  • In 2003, an infant without complications averaged $1,700 in hospital charges, while an infant born prematurely or at low birthweight averaged charges of $77,000 and had an average length of stay of 24.2 days. (Agency for Healthcare Research and Quality, 2003 Nationwide Inpatient Sample. Prepared by the March of Dimes Perinatal Data Center, 2005)
  • The average total paid charges for an infant with a disorder relating to short gestation and unspecified low birthweight were $214,445. (Society of Actuaries Large Claim Database: Updated 2006 for claim years 1997-1999)
  • Medicaid is billed for about one-third of uncomplicated newborn stays compared with 58 percent billed to private insurance, but for babies readmitted to the hospital, similar proportions of hospital stays are billed to Medicaid (47 percent) and private insurance (46 percent). Thus,Medicaid bears a larger burden of complicated newborn and neonatal care than private insurance. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • Various newborn conditions, including single live births, are among the Top 30 most costly claims with total paid charges in excess of $100,000. Short gestation and unspecified low birthweight ranks #1, single live born #2, twin birth ranks #12, other multiples live born #21, bulbus cordis anomalies and cardiac septal closure ranks #16, and other respiratory conditions of fetus and newborn #25. (Society of Actuaries Large Claim Database: Updated 2006 for claim years 1997-1999)
  • Congenital anomalies remain the leading cause of infant death in the United States. They also cause developmental disorders, disability, and are a leading cause of costly hospitalization. (National Center for Health Statistics, Births: Final Data for 2005)
  • Approximately 6 percent of all neonates are intubated and put on a respirator at some point during their stay, making this the third most common procedure performed on neonates. The most common diagnostic procedure among neonates — spinal tap, which is used to rule out neonatal meningitis — is performed on nearly 2 percent of all neonates. (HCUP Fact Book 4, Agency for Healthcare Research and Quality, October 2003)
  • A recent study has shown that involving parents in decision making and providing education can reduce length of stay by up to 7 days. (Melnyk BM et al, Reducing premature infants' length of stay and improving parents' mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics 2006 Nov)
  • Employer health costs for premature babies during the first year of their lives average $41,610, compared to $2,830 for babies born healthy and full term. (March of Dimes)
  • Additional costs in lost productivity average $2,766. (March of Dimes and Thomson Medstat, February 2006)
  • Eleven percent of newborns covered by an employer health plan are born prematurely. (March of Dimes 2005, adjusted to 2004 dollars)

Did you know?

A November 2006, Journal of the American Academy of Pediatrics Randomized controlled study showed that there were 7.9 fewer days for total Length of Stay for infants weighing less than 1,500 grams whose parents participated in an educational behavioral intervention program called “Creating Opportunities for Parent Empowerment” or COPE

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