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How Much Money Can Early Prenatal Care for Teen Pregnancies Save?: A Cost-Benefit Analysis

From the Department of Family Medicine, Medical University of South Carolina, Charleston

Correspondence: Corresponding author: William J. Hueston, MD, 295 Calhoun Street, PO Box 250192, Charleston, SC (E-mail: huestowj{at}musc.edu)

Background: Pregnant teens in the United States are at high risk for not obtaining prenatal care and for having low-birth weight deliveries. This observation suggests that significant cost savings might be realized if teens were able to obtain prenatal care in a timely fashion.

Methods: To determine the optimal time for teens to start prenatal care, we conducted a cost-benefit analysis from the perspective of Medicaid, the predominant payer for pregnancy-related services for teens. Cost projections were based on current recommended prenatal care testing, the cost of vaginal and cesarean deliveries, and the estimated costs for care of the child in the first year of life. We then compared average cost per person and performed sensitivity analyses based on when prenatal care would have started.

Results: Compared with no prenatal care, any prenatal care saves between $2,369 and $3,242 per person, depending on when care is initiated. All savings are related to reductions in the cost of caring for low-birth weight babies. We found no cost advantage to starting prenatal care earlier compared with later months.

Conclusion: If prenatal care does reduce the rate of low-birth weight babies, prenatal care is cost beneficial. If a program was developed to improve access for teens and applied to all pregnant teens not in care by 6 months' gestation, the program would have to average $95 or less per person to be cost beneficial if it reduced the number of low-birth weight deliveries by 50%.