Costs and consequences of comprehensive stillbirth assessment

Objective: The purpose of this study was to determine the consequences and costs of comprehensive stillbirth assessment. Study Design: Through reconstruction, we determined what consequences arise from assessment in the first 1477 stillborn pregnancies that were referred to the Wisconsin Stillbirth Service Program. Economic costs of stillbirth assessment were derived from real-time studies of those who performed the analyses and the costs of materials that were consumed. Results: When comprehensive, nonselective analysis is performed, new information that is relevant to recurrence risk estimation, prenatal diagnosis recommendation, or preconceptual, prenatal, perinatal, or neonatal treatment will arise in 51% of stillborn infants. The real cost of such assessment is approximately $1450 per assessment, or approximately $12 per cared-for pregnancy. Conclusion: Substantial relevant information can be learned from stillbirth assessment at a modest economic cost. Programs that can provide comprehensive stillbirth assessment services should become part of routine pregnancy care. (Am J Obstet Gynecol 2002;186:1027-34.)