Published online Nov 10, 2015. doi: 10.5317/wjog.v4.i4.102
Peer-review started: March 28, 2015
First decision: June 3, 2015
Revised: June 15, 2015
Accepted: August 4, 2015
Article in press: August 7, 2015
Published online: November 10, 2015
AIM: To describe maternity and newborn charges for an economic analysis of surrogate pregnancies on the health care resource utilization.
METHODS: A retrospective chart review of all women identified as being surrogates and the infants born from these pregnancies was performed between January 1, 2012 and December 31, 2013. Selected maternity diagnoses, mode of delivery, duration of hospitalization, and hospital charges were collected together with infants’ birth weights, gestational age, length of hospital stay, and hospital charges. Charges associated with the in vitro fertilization cycles, artificial insemination, or embryo(s) transfer into the surrogate were not considered in the maternity charges. A ratio contrasting the maternity hospital charges for the surrogate carrier was compared as a ratio to the mean charges for 2540 infants delivered in 2013 after natural conception and adjusted to the baseline hospital charges for both maternity and newborn care.
RESULTS: Analysis of sixty-nine infants delivered from both gestational and traditional surrogate women found an increased in multiple births, NICU admission, and length of stay with hospital charges several multiples beyond that of a term infant conceived naturally and provided care in our nursery. Among singletons and twins (per infant) hospital charges were increased 26 times (P < 0.001) and in triplets charges were increased 173 times (P < 0.0001) when compared to a term infant provided care in a normal nursery at our center.
CONCLUSION: Maternity costs for surrogates exceed those of women who conceive naturally, and these costs are especially magnified in women with triplets and multiple births.
Core tip: Surrogate pregnancies result in higher maternity and newborn costs with increased rates of multiple births and creates a moral hazard for hospitals. This increase occurs despite of the fact that surrogate mothers are prescreened for health and reproductive ability. Reduction in multiple embryo transfer would reduce the adverse economic impact of surrogate pregnancy, maternity and newborn costs.