title: Costs of hospitalization in preterm infants: impact of antenatal steroid therapy.
abstract: OBJECTIVE
  To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS).
  
  
  METHODS
  Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique.
  
  
  RESULTS
  Of 220 patients that met the inclusion criteria, 211 (96%) charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU). In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p=0.008). The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p=0.008) and a 49% reduction of NICU length of stay (p=0.011).
  
  
  CONCLUSIONS
  ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age.
authors.affiliation: Discipline of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. Electronic address: joicemeneguel@uol.com.br.
authors.forename: Joice Fabiola Meneguel
authors.initials: JF
authors.lastname: Ogata
authors.affiliation: Discipline of Gynecology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Marcelo Cunio Machado
authors.initials: MC
authors.lastname: Fonseca
authors.affiliation: Discipline of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Milton Harumi
authors.initials: MH
authors.lastname: Miyoshi
authors.affiliation: Discipline of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Maria Fernanda Branco de
authors.initials: MF
authors.lastname: Almeida
authors.affiliation: Discipline of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Ruth
authors.initials: R
authors.lastname: Guinsburg
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001938:Brazil; D005260:Female; D005865:Gestational Age; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007230:Infant, Low Birth Weight / Q000254:growth & development; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000191:economics*
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Costs and cost analysis; Custos e análise de custos; Glucocorticoides; Glucocorticoids; Hospitalization; Hospitalização; Prematuro; Preterm infant