Aggressive Tx less cost effective for low-birth-weight infants.(Obstetrics)

RENO, NEV. -- From a societal perspective, the most cost-effective course of action for impending preterm delivery at 24 weeks' gestation is an unwillingness on the part of the physician to perform cesarean section, Gianni Cazan-London, M.D., and colleagues reported in a poster presented at the annual meeting of the Society for Maternal-Fetal Medicine.

The researchers, from the University of Michigan Health System in Ann Arbor, conducted a cost-benefit analysis comparing aggressive management (willingness to perform cesarean section) with nonaggressive management (unwillingness to perform cesarean section).

If the overall goal is simply to produce a surviving infant, the choice of management has only a minimal effect on overall costs, with aggressive management costing $38,434 more than nonaggressive management.

On the other hand, if the goal is to produce a surviving infant who is healthy, aggressive management costs $690,969 more per healthy survivor than does nonaggressive management.

While aggressive management does slightly improve the chances of producing a healthy survivor, it also doubles the probability of producing an infant with major and costly morbidity, according to the analysis.

The investigators based their ...