Multiple births 20 times more expensive than singletons

A retrospective analysis of more than 400,000 U.S. births over nearly 6 years shows that delivery of triplets or more costs 20 times as much as a singleton. Published in The American Journal of Obstetrics and Gynecology, the report may be the first to look at medical expenses for both maternal and infant care associated with IVF-assisted pregnancy.

The analysis, based on data from the Truven Health MarketScan Commercial Claims and Encounters, included 437,924 deliveries of live-born infants to women aged 19 to 45 from January 2005 to September 2010. Costs included payments made by insurers and patients. Expenses from 27 weeks before delivery to 1 month after delivery were included for mothers, and for infants, included all expenses until their first birthday. A generalized linear model was used to estimate adjusted cost.

Of the deliveries, 97.02% were singletons, 2.85% were twins, and 0.13% were triplets or higher. For singletons, the adjusted total all-cause health care cost was $21,458 (95% CI, $21,302-$21,614) per delivery, versus $104,831 (95% CI, $103,402-$106,280) for twins and $407,199 (95% CI, $384,984-$430,695) for triplets or more.

Incidence of systemic and localized comorbidity was significantly higher in women with multiple pregnancies than with singletons (P<.0001) and twins and triplets were more likely than singletons to have stayed in a neonatal intensive care unit (P<.0001). 

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