{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:46:00Z","timestamp":1792291560150,"version":"4.4.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,4,1]]},"abstract":"<jats:p>OBJECTIVES. Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth.<\/jats:p>\n               <jats:p>METHODS. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined.<\/jats:p>\n               <jats:p>RESULTS. Overall, 14033 of 76901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants.<\/jats:p>\n               <jats:p>CONCLUSIONS. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.<\/jats:p>","DOI":"10.1542\/peds.2006-1729","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T01:43:40Z","timestamp":1173145420000},"page":"e866-e874","source":"Crossref","is-referenced-by-count":120,"title":["Preterm Birth\u2013Associated Cost of Early Intervention Services: An Analysis by Gestational Age"],"prefix":"10.1542","volume":"119","author":[{"given":"Karen M.","family":"Clements","sequence":"first","affiliation":[{"name":"Center for Community Health, Massachusetts Department of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanda D.","family":"Barfield","sequence":"additional","affiliation":[{"name":"Center for Community Health, Massachusetts Department of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Femi","family":"Ayadi","sequence":"additional","affiliation":[{"name":"Healthcare Administration Program, School of Business, University of Houston-Clear Lake, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Wilber","sequence":"additional","affiliation":[{"name":"Center for Community Health, Massachusetts Department of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2007,4,1]]},"reference":[{"key":"2021120823311117500_R1","doi-asserted-by":"crossref","unstructured":"Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med.\u20082004;9:429\u2013435","DOI":"10.1016\/j.siny.2004.04.002"},{"key":"2021120823311117500_R2","doi-asserted-by":"crossref","unstructured":"Christou H, Brodsky D. Lung injury and bronchopulmonary dysplasia in newborn infants. J Intensive Care Med.\u20082005;20:76\u201387","DOI":"10.1177\/0885066604273494"},{"key":"2021120823311117500_R3","doi-asserted-by":"crossref","unstructured":"Ward RM, Beachy JC. Neonatal complications following preterm birth. Br J Gynecol.\u20082003;110(suppl 20):8\u201316","DOI":"10.1046\/j.1471-0528.2003.00012.x"},{"key":"2021120823311117500_R4","doi-asserted-by":"crossref","unstructured":"Hintz SR, Kendrick DE, Vohr BR, Poole WK, Higgins RD. National Institute of Child Health and Human Development Neonatal Research Network. Changes in neurodevelopmental outcomes at 18 to 22 months' corrected age among infants of less than 25 weeks' gestational age born in 1993\u20131999. Pediatrics.\u20082005;115:1645\u20131651","DOI":"10.1542\/peds.2004-2215"},{"key":"2021120823311117500_R5","doi-asserted-by":"crossref","unstructured":"van Baar AL, van Wassenaer AG, Briet JM, Dekker FW, Kok JH. Very preterm birth is associated with disabilities in multiple developmental domains. J Pediatr Psychol.\u20082005;30:247\u2013255","DOI":"10.1093\/jpepsy\/jsi035"},{"key":"2021120823311117500_R6","doi-asserted-by":"crossref","unstructured":"Shankaran S, Johnson Y, Langer JC. Outcome of extremely-low-birth-weight infants at highest risk: gestational age &lt; or =24 weeks, birth weight &lt; or =750 g, and 1-minute Apgar &lt; or =3. Am J Obstet Gynecol.\u20082004;191:1084\u20131091","DOI":"10.1016\/j.ajog.2004.05.032"},{"key":"2021120823311117500_R7","doi-asserted-by":"crossref","unstructured":"Repka MX. Ophthalmological problems of the premature infant. Ment Retard Dev Disabil Res Rev.\u20082002;8:249\u2013257","DOI":"10.1002\/mrdd.10045"},{"key":"2021120823311117500_R8","doi-asserted-by":"crossref","unstructured":"Colvin M, McGuire W, Fowlie PW. Neurodevelopmental outcomes after preterm birth. BMJ.\u20082004;329:1390\u20131393","DOI":"10.1136\/bmj.329.7479.1390"},{"key":"2021120823311117500_R9","doi-asserted-by":"crossref","unstructured":"Cooke RW, Foulder-Hughes L, Newsham D, Clarke D. Ophthalmic impairment at 7 years of age in children born very preterm. Arch Dis Child Fetal Neonatal Ed.\u20082004;89:F249\u2013F253","DOI":"10.1136\/adc.2002.023374"},{"key":"2021120823311117500_R10","doi-asserted-by":"crossref","unstructured":"Foulder-Hughes LA, Cooke RW. Motor, cognitive, and behavioural disorders in children born very preterm. Dev Med Child Neurol.\u20082003;45:97\u2013103","DOI":"10.1111\/j.1469-8749.2003.tb00912.x"},{"key":"2021120823311117500_R11","unstructured":"Institute of Medicine. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press; 2006"},{"key":"2021120823311117500_R12","doi-asserted-by":"crossref","unstructured":"Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol.\u20082003;102:488\u2013492","DOI":"10.1097\/00006250-200309000-00011"},{"key":"2021120823311117500_R13","doi-asserted-by":"crossref","unstructured":"St John EB, Nelson KG, Cliver SP, Bishnoi RR, Goldenberg RL. Cost of neonatal care according to gestational age at birth and survival status. Am J Obstet Gynecol.\u20082000;182(pt 1):170\u2013175","DOI":"10.1016\/S0002-9378(00)70509-6"},{"key":"2021120823311117500_R14","doi-asserted-by":"crossref","unstructured":"Schmitt SK, Sneed L, Phibbs CS. Costs of newborn care in California: a population-based study. Pediatrics.\u20082006;117:154\u2013160","DOI":"10.1542\/peds.2005-0484"},{"key":"2021120823311117500_R15","doi-asserted-by":"crossref","unstructured":"Rogowski J. Cost-effectiveness of care for very low birth weight infants. Pediatrics.\u20081998;102:35\u201343","DOI":"10.1542\/peds.102.1.35"},{"key":"2021120823311117500_R16","doi-asserted-by":"crossref","unstructured":"Lewitt EM, Baker LS, Corman H, Shiono PH. The direct cost of low birth weight. Future Child.\u20081995;5:35\u201356","DOI":"10.2307\/1602506"},{"key":"2021120823311117500_R17","doi-asserted-by":"crossref","unstructured":"Bardin C, Piuze G, Papageorgiou A. Outcome at 5 years of age of SGA and AGA infants born less than 28 weeks of gestation. Semin Perinatol.\u20082004;28:288\u2013294","DOI":"10.1053\/j.semperi.2004.08.006"},{"key":"2021120823311117500_R18","doi-asserted-by":"crossref","unstructured":"Chaikind S, Corman H. The impact of low birthweight on special education costs. J Health Econ.\u20081991;10:291\u2013311","DOI":"10.1016\/0167-6296(91)90031-H"},{"key":"2021120823311117500_R19","unstructured":"National Early Childhood TA Center. Early Intervention Program for Infants and Toddlers with Disabilities (Part C of IDEA). Available at: www.nectac.org\/partc\/partc.asp#overview. Accessed September 5, 2006"},{"key":"2021120823311117500_R20","doi-asserted-by":"crossref","unstructured":"Clements KM, Barfield WD, Kotelchuck M, Lee KG, Wilber N. Birth characteristics associated with early intervention referral, evaluation for eligibility, and program eligibility in the first year of life. Matern Child Health J.\u20082006;10:433\u2013441","DOI":"10.1007\/s10995-006-0080-4"},{"key":"2021120823311117500_R21","doi-asserted-by":"crossref","unstructured":"Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol.\u20081996;87:163\u2013168","DOI":"10.1016\/0029-7844(95)00386-X"},{"key":"2021120823311117500_R22","doi-asserted-by":"crossref","unstructured":"Lazar J, Kotelchuck M, Nannini A, Barger M. Identifying multiple gestation groups using state-level birth and fetal death certificate data. Matern Child Health J.\u20082006;10:225\u2013228","DOI":"10.1007\/s10995-005-0043-1"},{"key":"2021120823311117500_R23","doi-asserted-by":"crossref","unstructured":"Lorenz JM. The outcome of extreme prematurity. Semin Perinatol.\u20082001;25:348\u201359","DOI":"10.1053\/sper.2001.27164"},{"key":"2021120823311117500_R24","unstructured":"Massachusetts Births 2003. Boston, MA: Division of Research and Epidemiology, Center for Health Information, Statistics, Research, and Evaluation, Massachusetts Department of Pubic Health; April 2005"},{"key":"2021120823311117500_R25","unstructured":"Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menaker F, Munson ML. Births: final data for 2003. Natl Vital Stat Rep.\u20082005;54:1\u2013116"},{"key":"2021120823311117500_R26","doi-asserted-by":"crossref","unstructured":"Jansson-Verkasalo E, Valkama M, Vainionpaa L, Paakko E, Ilkko E, Lehtihalmes M. Language development in very low birth weight preterm children: a follow-up study. Folia Phoniatr Logop.\u20082004;56:108\u2013119","DOI":"10.1159\/000076062"},{"key":"2021120823311117500_R27","doi-asserted-by":"crossref","unstructured":"Rvachew S, Creighton D, Feldman N, Sauve R. Vocal development of infants with very low birth weight. Clin Linguist Phon.\u20082005;19:275\u2013294","DOI":"10.1080\/02699200410001703457"},{"key":"2021120823311117500_R28","doi-asserted-by":"crossref","unstructured":"Roohan PJ, Josberger RE, Acar J, Dabir P, Feder HM, Gagliano PJ. Validation of birth certificate data in New York State. J Community Health.\u20082003;28:335\u2013346","DOI":"10.1023\/A:1025492512915"},{"key":"2021120823311117500_R29","unstructured":"Shackelford J. State and jurisdictional eligibility definitions for infants and toddlers with disabilities under IDEA. NECTAC Notes.\u20082005;19:1\u201315"},{"key":"2021120823311117500_R30","unstructured":"Chambers JG, Fowler WJ. Geographic Variation in Public School's Costs. Washington, DC: US Department of Education, National Center for Health Statistics; 1998. Working Paper No. 98-04"},{"key":"2021120823311117500_R31","doi-asserted-by":"crossref","unstructured":"Schmid SG. Geographic variation in medical costs: evidence from HMOs. Health Aff (Millwood).\u20081995;14:271\u2013276","DOI":"10.1377\/hlthaff.14.1.271"},{"key":"2021120823311117500_R32","doi-asserted-by":"crossref","unstructured":"DeNavas-Walt C, Proctor BD, Lee CH. Income, Poverty, and Health Insurance Coverage in the United States. Washington, DC: US Government Printing Office, Census Bureau, Current Population Reports; 2006. P60-231","DOI":"10.1037\/e615712007-001"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/119\/4\/e866\/1119363\/zpe0040700e866.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/119\/4\/e866\/1119363\/zpe0040700e866.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T04:11:53Z","timestamp":1639023113000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/119\/4\/e866\/70158\/Preterm-Birth-Associated-Cost-of-Early"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,4,1]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2007,4,1]]},"published-print":{"date-parts":[[2007,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2006-1729","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,4,1]]}}}