Marzouk Alicia, Filipovic-Pierucci Antoine, Baud Olivier, Tsatsaris Vassilis, Ego Anne, Charles Marie-Aline, Goffinet François, Evain-Brion Danièle, Durand-Zaleski Isabelle
URC ECO, Hôtel Dieu 1 Place du Parvis de Notre Dame, 75004, Paris, France.
PREMUP Foundation, Paris, France.
BMC Health Serv Res. 2017 Mar 21;17(1):221. doi: 10.1186/s12913-017-2155-x.
Small for gestational age (SGA) infants are at increased risk for preterm birth morbidities as well as a range of adverse perinatal outcomes that result in part from associated premature birth. We sought to evaluate the costs of SGA versus appropriate for gestational age (AGA) infants in France from pregnancy through the first year of life and separate the contributions of prematurity from the contribution of foetal growth on costs.
This is a cross-sectional population-based study using national hospital discharge data from French public and private hospitals. SGA infants were defined as newborns with a birth weight below the 10th percentile of French intrauterine growth curves adjusted for foetal sex. AGA infants were defined as newborns with a birth weight between the 25th and the 75th. All births were selected between January 1st, 2011 and December 31st, 2011. Costs were calculated from the hospital perspective for both mothers and children using their diagnostic related group and the French national cost study. Hospital outcomes were extracted from the database and compared by gestational age and mode of delivery.
Of 777,720 total births in 2011, 84,688 SGA births (10.9%) and 395,760 AGA births (50.8%) were identified. After adjustment for gestational age, the cost for an SGA infant was €2,783 higher than for an AGA infant. The total maternal and infant hospital cost of SGA in France was estimated at 23% the total cost for deliveries. The high cost is explained by higher complication rates, more frequent hospital readmissions and longer lengths of stay.
Being small for gestational age is an independent contributor to 1-year hospital costs for both mothers and infants.
小于胎龄儿（SGA）发生早产相关疾病以及一系列不良围产期结局的风险增加，部分不良结局是由早产所致。我们旨在评估法国SGA婴儿与适于胎龄儿（AGA）从孕期至出生后第一年的花费，并区分早产和胎儿生长对花费的影响。
这是一项基于人群的横断面研究，使用法国公立和私立医院的全国住院数据。SGA婴儿定义为出生体重低于根据胎儿性别调整后的法国子宫内生长曲线第10百分位数的新生儿。AGA婴儿定义为出生体重在第25至第75百分位数之间的新生儿。所有分娩均选自2011年1月1日至2011年12月31日。从医院角度，使用诊断相关组和法国国家成本研究计算母亲和儿童的费用。从数据库中提取医院结局，并按胎龄和分娩方式进行比较。
2011年共777,720例分娩，其中84,688例（10.9%）为SGA分娩，395,760例（50.8%）为AGA分娩。调整胎龄后，SGA婴儿的花费比AGA婴儿高2,783欧元。法国SGA母婴住院总费用估计占分娩总费用的23%。高费用是由更高的并发症发生率、更频繁的再次入院和更长的住院时间所致。
小于胎龄是导致母亲和婴儿1年住院费用增加的独立因素。
