The costs of low birth weight
The costs of low birth weight
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DOI：
10.1162/003355305774268228
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发表时间：
2005-08-01
影响因子：
13.7
通讯作者：
Lee, DS
中科院分区：
文献类型：
--
作者：
Almond, D;Chay, KY;Lee, DS
低出生体重儿（LBW）经历严重的健康和发育困难，可能会给社会带来巨大的成本。然而，估计返回到LBW预防横断面协会可能会被遗漏的变量，如遗传因素的偏见。为了解决这个问题，我们比较了在美国出生的所有双胞胎中体重较重和体重较轻的婴儿的住院费用、出生时的健康状况和婴儿死亡率。我们还研究了在控制详细的背景特征后，母亲在怀孕期间吸烟的影响-在美国LBW的主要危险因素-对单胎分娩的健康。这两种分析都暗示了出生体重不足本身的影响比以前认为的要小得多，这表明了两种可能性：1）现有的估计将出生体重不足的真实成本和后果夸大了至少四倍，多达二十倍;或2）不同的预防出生体重不足的干预措施具有不同的健康和成本后果，这意味着假定减少出生体重不足的单一回报的政策努力将是次优的。
Low birth weight (LBW) infants experience severe health and developmental difficulties that can impose large costs on society. However, estimates of the return to LBW-prevention from cross-sectional associations may be biased by omitted variables, such as genetic factors. To address this, we compare the hospital costs, health at birth, and infant mortality rates between heavier and lighter infants from all twin pairs born in the United States. We also examine the effect of maternal smoking during pregnancy-the leading risk factor for LBW in the United States-on health among singleton births after controlling for detailed background characteristics. Both analyses imply substantially smaller effects of LBW per se than previously thought, suggesting two possibilities: 1) existing estimates overstate the true costs and consequences of LBW by at least a factor of four and by as much as a factor of twenty; or 2) different LBW-preventing interventions have different health and cost consequences, implying that policy efforts that presume a single return to reducing LBW will be suboptimal.