Length of stay and cost of birth hospitalization: effects of subfertility and ART

Objective The objective of this study is to measure delivery length of stay (LOS) and cost as proxies for infant morbidity in assisted reproductive technology (ART) and subfertile deliveries. Study Design Massachusetts singleton births, >= 23 weeks gestational age (GA) between 2004 and 2010, were linked with ART data, vital records, and hospital discharges. LOS and costs (2010 US dollars) of infants born to fertile (no ART or indicators of infertility), subfertile (indicators of infertility but no ART), and ART-treated (linked to ART data) deliveries were compared. Least-square means and SE were calculated. Results Of 345,756 singletons (fertile n = 332,481, subfertile n = 4987, and ART-treated n = 8288), overall LOS was 3.79 +/- 0.01, 4.32 +/- 0.15, and 4.90 +/- 0.04 days, and costs were $2980 +/- 6, $3217 +/- 58, and $4483 +/- 62, respectively. GA and birthweight predicted much of the intergroup difference. Conclusion Maternal fertility group was not an independent predictor of infant LOS and costs. Prematurity and birthweight were driving factors in resource utilization.