Respiratory morbidity, healthcare resource use, and cost burden associated with extremely preterm birth in The Netherlands

Eline Houben, Csaba Siffel, Jetty Overbeek, Fernie Penning-van Beest, Victoria Niklas, Sujata P. Sarda*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
28 Downloads (Pure)


Background: Extremely preterm (EP) infants have high rates of respiratory morbidity and correspondingly high healthcare resource utilization. Objectives: Data from the PHARMO Perinatal Research Network were analyzed to quantify the burden of EP birth in the Netherlands. Methods: A retrospective analysis included infants <28 weeks gestational age with a birth record in the Perinatal Registry (1999–2015) and data in the PHARMO Database Network. Outcomes of interest included select comorbidities, hospital readmissions, and costs of hospitalization and medication up to 1- and 2-years corrected age. Outcomes were stratified by birth period (1999–2005, 2000–2009, 2010–2015) and by diagnosis of bronchopulmonary dysplasia (BPD) and chronic lung disease (CLD). Results: The cohort included 168 EP infants (37 born 1999–2005, 51 born 2006–2009, 80 born 2010–2015). Median (Q1–Q3) birth weights decreased by birth period from 970 (840–1,035) g in 1999–2005 to 853 (695–983) g in 2010–2015. Overall, BPD and CLD were reported during the birth hospitalization in 40% and 29% of infants, respectively; rates of BPD increased and rates of CLD decreased by birth period. Eighty-four percent of EP infants had an additional comorbidity. Mean (standard deviation) costs of birth hospitalization were €110,600 (€73,000) for 1999–2005, €119,350 (€60,650) for 2006–2009, and €138,800 (€130,100) for 2010–2015. Birth hospitalization and total costs for up to 1- and 2-years corrected age were higher for infants with BPD and/or CLD than for those without either complication. Conclusion: Healthcare resource utilization and costs for EP infants, especially for those with respiratory morbidities, increased between 1999 and 2015. Future cost-effectiveness analyses are essential to determine the economic impact of this change and underscore the need for new therapeutic interventions to decrease clinical sequelae in this vulnerable population.

Original languageEnglish
Pages (from-to)1290-1298
Number of pages9
JournalJournal of Medical Economics
Issue number1
Publication statusPublished - 19 Nov 2021

Bibliographical note

Funding Information:
This study was funded by Shire, a Takeda company. Takeda provided funding to Excel Medical Affairs for support in writing and editing this manuscript.

Funding Information:
The authors thank all healthcare providers contributing information to the PHARMO Database Network as well as all contributors from the Netherlands Perinatal Registry (Perined) for their assistance and for granting access to Perined. Mark Poirier and Shirley Louise-May of Excel Medical Affairs (Fairfield, CT, USA) provided writing assistance for this manuscript.

Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


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