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Although the health sequelae of smoking during pregnancy are well documented, relatively little is known about its long-term economic implications. The objective of this study was to analyse individual-level data on maternal smokingbehaviour and sociodemographic, perinatal and resource utilisation variables in order to estimate the association between smoking during pregnancy and hospital inpatient service utilisation and costs through the first 5 years of the infant's life. Data from the Oxford Record Linkage Study, a collection of birth registrations, death certificates and statistical abstracts of hospital inpatient and day case admissions formed the basis of the investigation. The study population comprised all infants born to women who both lived and delivered in Oxfordshire or West Berkshire during the period 1 January 1980-31 December 1989 (n = 119,028). The cost of each hospital admission, including the initial birth admission, was estimated by multiplying the length of stay by the per diem cost of the respective specialty ([pounds sterling] 1998-1999 sterling). The effect of maternal smoking behaviour on cumulative 5-year hospital inpatient service utilisation and costs was analysed in a series of multivariate analyses, taking account of confounding clinical and sociodemographic factors. Infants born to women who reported smoking during pregnancy were hospitalised for a significantly greater number of days than infants born to women who had either never smoked or had smoked in the past (P Keywords: Smoking; Pregnancy; Inpatient service utilisation; Inpatient service costs; Multivariate; UK

Objectives. To compare the cumulative use and cost of hospital inpatient services to 5 years of age by individuals divided into 4 subgroups by gestational age at birth. Design. Costs applied to the hospital service utilization profile of each infant born in 2 areas covered by the Oxford Record Linkage Study during 1970-1993. Setting. Oxfordshire and West Berkshire, southern United Kingdom. Subjects. 239694 individuals divided into 4 subgroups by gestational age at birth: Main Outcome Measures. Number and duration of hospital admissions during the first 5 years of life and costs, expressed in [pounds sterling] sterling and valued at 1998-1999 prices, of hospital inpatient services. Results. The total duration of hospital admissions for infants born at Conclusions. Preterm birth is a major predictor of how much an individual will cost hospital service providers during the first 5 years of life. Pediatrics 2003;112: 1290-1297; preterm birth, admissions, resource utilization, costs., The high rates of morbidity and mortality arising from preterm birth impose a considerable burden on finite health care resources. Preterm infants are at increased risk of a range of [...]