Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104-1213, USA,
Matern Child Health J. 2013 Dec;17(10):1835-41. doi: 10.1007/s10995-012-1203-8.
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.
美国的胎儿死亡人数占总出生人数的近 1%。与胎儿死亡相关的医院治疗费用可能相当高。然而，关于胎儿死亡的经济负担的数据非常有限。我们对密歇根州三家大医院的十年间的死产病例进行了回顾性病历审查，并确定了这些分娩的医疗并发症、医院费用和住院时间。死产母亲与同年在同一家医院分娩活产婴儿的同龄母亲相匹配。我们的最终样本包括 533 例死产和 1053 例匹配的活产。死产的平均医院费用为 7495 美元（±7015 美元），平均住院时间为 2.8 天（±2.8 天）。患有严重的产妇医疗并发症与死产妇女的更高费用和更长的住院时间相关。20 周至 28 周妊娠期的早期死产、硬膜外/脊髓/全身麻醉和剖宫产也与更长的住院时间相关。死产妇女的平均医院费用比活产妇女高出 750 多美元，但两者的住院时间没有显著差异。这项研究表明，死产与产妇的高额医院费用有关。未来研究应进一步检查死产除分娩之外的经济影响，例如与后续妊娠中增加的检测和护理相关的成本，以更好地了解死产的总体经济影响。
