Swedish study reveals high societal costs for extremely preterm infants

Children born before 24 weeks of gestation are linked to high societal costs throughout childhood. Costs are highest during the first year of life, but the need for support persists for many years. This is shown in a study by researchers at the University of Gothenburg, Sweden.

Being born before 24 weeks usually means that the child needs help with breathing, maintaining body temperature, and receiving nutrition. Care is provided in neonatal units and may continue for weeks or months. This concerns only a small number of children each year - just a fraction of the approximately 115,000 children born in Sweden annually.

The study shows how costs change over time and may help improve how societal support is tailored, while also highlighting that the need for support persists long after the initial period of care. It is based on register data from 344 children in Sweden who were born before 24 weeks of gestation between 2007 and 2018 and were followed for an average of nearly eight years.

Hanna Gyllensten, Senior Lecturer at the Sahlgrenska Academy, University of Gothenburg, is one of the authors of the study:

"We see that costs are highest during the first year of life, averaging around SEK 1.7 million per child. At the same time, there are large differences between children. Those who experience severe complications early in life often have more long-term and extensive support needs," says Hanna Gyllensten.

Costs shift over time

Needs vary across children. Children with severe early complications often have greater and more long-term support needs. More than 80 percent of healthcare costs arise during the child's first year.

Chatarina Löfqvist is Professor of Caring Science at the Sahlgrenska Academy, University of Gothenburg, and first authors of the article:

"After a few years, we see a clear shift: healthcare no longer accounts for the largest share of costs; instead, societal support for the family becomes the largest component. These are long-term support measures that follow the child through childhood and reflect needs that remain long after acute care has ended," says Chatarina Löfqvist.

An important next step is to develop follow-up programs where the needs of the child and family are central, and where support efforts can be coordinated over time.

The study does not include all types of costs, such as special education or informal care.