Abstract
Background: Congenital cutaneous hemangiomas (CCH) are vascular tumors that develop in utero and rarely require treatment during the neonatal period. Little is known regarding the characteristics of newborns with CCH. Our goal is to describe the burden of CCH on newborn hospital stays in the United States (US). Methods: We evaluated data from the National Inpatient Sample from 2009-2015. A weighted multivariate logistic regression model was used to determine predictors for having a CCH in newborns. A weighted multivariate linear regression model was used to determine predictors for length of stay and cost of care. Weighted frequencies of various diagnostic procedures were compared using Rao-Scott Chi-Square tests. Results: We identified 42,666 newborns with CCH and 24,992,290 newborns without CCH (prevalence 17.0 per 100,000). Controlling for all covariates, female (adjusted odds ratio [aOR] 1.52), white (aOR 1.69) newborns from higher income families (aOR 1.44) in metropolitan cities (aOR 1.17) were most likely to be born with CCH (p<0.001 for all). Newborns with CCH underwent more diagnostic procedures, including magnetic resonance imaging (risk ratio [RR] 6.45, p<0.001). Newborns with CCH who were premature (aOR 3.88), white (aOR 1.14), underwent more procedures (aOR 8.81), and were born in urban hospitals (aOR 2.66) had the greatest cost of care (p<0.001 for all). Premature (aOR 3.74) newborns with CCH in urban hospitals (aOR 1.31) had longer hospital stays (p<0.001 for all). The average cost of care per newborn stay with CCH was $59,709. Cost of care and length of stay increased from 2009 ($26,486/7.3 days) to 2015 ($92,852/13.0 days) for newborns with CCH.Conclusion: This study provides nationally representative estimates of the burden of CCH on newborn care in the US. Understanding contributors to costly hospital stays for newborns with CCH is critical in developing interventions to reduce the impact of CCH on newborn care.
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