Long‐Term Societal Costs After Births Before 24 Weeks of Gestation in Sweden

AIM: Extremely preterm birth is associated with high morbidity and long-term support needs. This study estimated long-term medical and non-medical costs throughout childhood among children born before 24 weeks of gestation in Sweden. METHODS: This nationwide register-based study included 344 infants born before 24 weeks of gestation in Sweden between 2007 and 2018 who survived at least one year. Individual-level data from national health registers and social insurance records were linked to estimate costs of hospital care, outpatient care, prescribed drugs and parental support until the end of 2022. Costs were analysed from a societal perspective and expressed in 2022 Swedish kronor. RESULTS: The mean follow up time was 7.8 years. Average total costs per child were 1.68 million Swedish kronor in the first year of life, with medical care accounting for more than 80% of expenditures. Non-medical costs increased during childhood and exceeded medical costs from approximately four years of age. Neonatal morbidities, including bronchopulmonary dysplasia, treated retinopathy of prematurity, and severe intraventricular haemorrhage, were associated with sustained long-term costs. CONCLUSION: Birth before 24 weeks of gestation was linked to high long-term costs. Early costs were related to hospital care, while long-term costs increasingly reflected social and welfare support.