The impact of prenatal exposure to cocaine on newborn costs and length of stay.

OBJECTIVE

Our intention is to determine newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs.

DATA SOURCES AND STUDY SETTING

All parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992.

STUDY DESIGN

A cross-sectional analysis used multivariate, loglinear regressions to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs, adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and newborn infection.

DATA COLLECTION/EXTRACTION METHODS: Urine specimens, with linked obstetric sheets and discharge abstracts, provided information on exposure, prenatal behaviors, costs, length of stay, and discharge disposition.

PRINCIPAL FINDINGS

Infants exposed to cocaine or some other illicit drug stay approximately seven days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and newborn infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.