Neonatal Macroglossia: Demographics, Cost of Care, and Associated Comorbidities

Abstract

Objectives: (1) Examine the birth prevalence of macroglossia, assessing for differences across sex, race, socioeconomic status, and geographic location. (2) Identify comorbidities associated with isolated and syndromic forms of macroglossia and determine how such factors may influence length of stay (LOS) and cost of admission. Methods: Retrospective cross-sectional study using the 2006 and 2009 Kids’ Inpatient Databases (KID). Results: The national birth prevalence of macroglossia was 3.4 out of 10,000 births (n = 556) with a higher rate in females (3.9/10,000, P = .001) and blacks (4.5/10,000, P = .01). Patients were classified as isolated (n = 423, 76%) or syndromic (n = 133, 24%) based on associated diagnoses. Syndromic cases were more prevalent in the West ( P = .01). LOS and cost were increased in the syndromic group (26.2 days vs 4.8 days, P < .01; $30.1k vs $3.9k, P < .01), while LOS and cost for isolated macroglossia were similar to the general population. The rate of concurrent cardiac anomalies, cleft palate, and Down syndrome was increased in patients with macroglossia compared to unaffected newborns ( P < .01). Rates of respiratory distress, feeding problems, GERD, endotracheal intubation, and prolonged ventilator support were higher in the syndromic group ( P < .01). Newborns with isolated macroglossia suffered these conditions at the same rate as the general population. Conclusions: The birth prevalence of macroglossia varies by sex, race, and geographic location. Prolonged LOS and increased cost are associated with syndromic forms of macroglossia. Syndromic comorbidities rather than enlargement of the tongue in and of itself appear to be the chief contributors to increased LOS and cost in this population.