THE IMPACT OF PRENATAL EXPOSURE TO COCAINE ON NEWBORN COSTS AND LENGTH OF STAY

Objective. Our intention is to determine newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit dr ugs. Data Sources and Study Setting. All parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. Study Design. A cross-sectional analysis used mult ivariate, loglinear regressions to analyze differences in costs and le ngth of stay between infants exposed and unexposed prenatally to cocai ne and other illicit drugs, adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, a nd newborn infection. Data Collection/Extraction Methods. Urine specim ens, with linked obstetric sheets and discharge abstracts, provided in formation on exposure, prenatal behaviors, costs, length of stay, and discharge disposition. Principal Findings. Infants exposed to cocaine or some other illicit drug stay approximately seven days longer at a c ost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and ne wborn infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimate s its impact on costs.