Economic considerations at the threshold of viability

Leah Yieh, Brian C. King, Susanne Hay, Dmitry Dukhovny, John A.F. Zupancic

Research output: Contribution to journalArticlepeer-review


Neonatal intensive care for infants born at 22–24 weeks has become more prevalent in the past three decades, but outcomes remain highly variable between centers, in part due to different approaches in management. With this increased frequency of intervention, there has been concern for a concurrent increase in costs of care for survivors. This article reviews the direct medical, direct non-medical, and indirect costs of care for periviable infants and their families, as well as the current limitations of published data. In addition, we highlight the cost-effectiveness of neonatal intensive care and various therapies offered to extremely preterm infants, while also considering the ethical dilemmas inherently tied to periviable decision-making. Strategies to improve the gaps in knowledge on the economic impact of the smallest infants are discussed.

Original languageEnglish (US)
Article number151547
JournalSeminars in Perinatology
Issue number2
StatePublished - Mar 2022

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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