Abstract
Preterm birth is a vital global health-economic problem. Health disorders provoked by it generate a high neonatal mortality rate. Prenatal corticosteroid prevention aims to reduce postnatal complications in premature infants. This survey covered two basic baby groups: work group of 89 premature infants that had been subjected to prenatal corticosteroid prophylaxis and a control group of 78 premature babies without prenatal prevention. The analysis of the pharmacoeconomic aspects of prenatal corticosteroid prevention enabled the comparison of clinical and therapeutic results, treatment costs, therapeutic expenditures, shortterm therapeutic effect, benefits and sequences from premature infants’ therapy. The analysis of clinical data obtained during this survey enabled the conclusion that when analyzing the combined effect of Dexamethasone prophylaxis, gestation week at birth and the age of the mother of premature infants with RDS, respiratory obstuction occurrence was mediated by the earlier gestation week at birth, older mother’s age and, at this background, it was restricted to a certain extent by prenatal corticosteroid administration. Conclusions: Prenatal corticosteroids cause reduction of premature infants’ treatment costs. The implementation of a smaller number of dexamethasone applications leads to smaller expenditures for premature infants’ treatment and care compared to those that have more dexamethasone applications.
Highlights
Preterm birth is a significant current public health problem
Prenatal corticosteroids are covered by the algorithm of Clinical Path 1 (CP1) Stationary care for high-risk pregnancy, Clinical Path 2 (CP2) Prenatal invasive pregnancy diagnostics and intensive care for pregnancy with realized risk and Clinical Path 3 (CP3) Birth
The costs of those clinical paths reimbursed by the National Health Insurance Fund (NHIF) are respectively: CP1 – 390 BGN, CP – 800 BGN and CP3 – 580 BGN
Summary
Preterm birth is a significant current public health problem. It is the most frequent cause for neonatal death in developed countries (Blencowe et al 2012, Goldenberg et al 2008, Heaman et al 2005, Heron 2012), represents 80% of all neonatal death incidence rate in the world (more than 1.1 million) (Howson et al 2012, Steer 2005) and more than 30% of that in Europe (Euro-Peristat 2010). Mihaylova A et al.: Cost analysis of neonates after prenatal corticosteroid prophylaxis
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