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Booming 'birth tourism' contributes to social, financial burdens in NICU

WASHINGTON — Infants born to pregnant mothers traveling for the primary purpose of delivering in the United States were reported to exhibit higher medical complexity, longer hospital stays and increased rehospitalization, according to data presented at the 2015 AAP National Conference and Exhibition.

“As birth tourism increases in our region, so do subsequent NICU admissions and significant social and financial burdens arising from the unanticipated medical needs of the babies,” Michel Mikhael, MD, FAAP, an attending neonatologist at the Children’s Hospital of Orange County, California, said in a press release.

While approximately 10% of all live birth neonates are admitted to the NICU, due to prematurity, congenital anomalies or other neonatal illness, there have been no studies examining the possible association between birth tourism and NICU hospitalization.

Michel Mikhael

To determine the impact of the birth tourism trend on the NICU At Children’s Hospital of Orange County, Mikhael and colleagues retrospectively reviewed the medical records of all admissions to NICU between February 2012 and January 2015. Researchers identified 46 neonates born to families who visited the U.S. with plans to deliver and return to their home countries after birth. These infants were compared with a control group of 100 randomly selected neonates.

According to study results, researchers observed no significant differences in birth weight, gestational age, gender or 5-minute Apgar score. The researchers noted that the birth tourism group, however, had a higher mortality rate (6% vs. 1%), longer median length of stay (14 days vs. 7 days) and were more likely to be rehospitalized within 30 days of discharge (16.2% vs. 5.2%).

In addition, the researchers examined social and financial impacts of birth tourism in the NICU. While all neonates in the birth tourism group were uninsured at birth, one-third were enrolled in public health care programs when families adopted U.S. residencies due to the complex health care of their children. Furthermore, four neonates were placed for adoption, which was not planned before birth.

“[This study] should not alter practices, but it should make us aware of the medical, social and financial challenges faced by birth tourism families and possibly the health delivery system,” Mikhael told Infectious Diseases in Children. “Larger studies to include all birth tourism babies, not only those admitted to the NICU, with focus on social and financial impact is warranted.” – by Bob Stott

For more information:
Mikhael M. Abstract 29097. Presented at: AAP National Conference and Exhibition; Oct. 24-27, 2015; Washington, D.C.

Disclosure: The researchers report no relevant financial disclosures.