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How much does Infant Mortality cost the Nation?

Infant mortality and low birthweight remain major public health issues in the U.S. Although infant mortality has decreased in the last decade, the gap between whites and minorities has not been closed. Infant mortality among African American women is more than twice that of white women. Low birthweight among African American women is more than twice that of white women. For Hispanics and Native Americans, the infant mortality and low birthweight rates are significantly higher than that of the white population. Therefore, minority families need special attention, focus and priority in perinatal health services.

Less attention has been paid to the problem of low birthweight and very low birthweight babies. In contrast to infant mortality, the last decade saw no significant drop in the rate of low birthweight. In fact, low birthweight now appears to be on the rise. The medical and social services that are required by low birthweight and very low birthweight infants are significant and the costs are high to society and the American taxpayer. Those babies that survive the first year incur medical bills averaging $93,800. First year expenses for the smallest survivors will average $273,900.

Significant savings can accrue from enabling mothers to add a few ounces to a baby's weight before birth. An increase of 250 grams (about 1/2 pound) in birth weight saves an average of $12,000 to $16,000 in first year medical expenses. Prenatal interventions that result in a normal birth (over 2500 grams or 5.5 pounds) saves $59,700 in medical expenses in the infant's first year. The long-term cost of low birthweight infants includes re-hospitalization costs, many other medical and social service costs and, when the child enters school, often large special education expenses. These public expenses can go on for a lifetime.

Decreased infant mortality rates are the result of dramatically improved medical technology keeping low birthweight infants alive who would have died 10 or 20 years ago. On the other hand, improving the low birthweight rate requires improvements in the practices and behavior of the women themselves while pregnant.

Risk-taking behaviors or inattention to good health practices while pregnant is undoubtedly the single major cause of low birthweight. The most effective way to change these behaviors is to engage women early in their pregnancies and to find ways to encourage them to make changes in their lifestyles and lives. Without ongoing, extensive community-based programs like Healthy Start, it is unlikely that the rate of low birthweight or the gap in racial disparity will be affected.

(Source: March of Dimes Perinatal Data Center. Rogowski, J. (1998) Cost-effectiveness of Care for Very Low Birthweight Infants. Pediatrics 012(1):35-43.)

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