Low Birthweight Births

Published November 2011

Low Birthweight Babies. Eight percent of babies born in the United States weigh less than 5.5 pounds, a rate that rose 12 percent from 1996 to 2006. Sixty‐seven percent of these low birthweight babies are born too early, before 37 weeks.

The Costs. Babies with low birthweights have a higher risk of physical and mental disabilities, including blindness, chronic lung disease and cerebral palsy. According to the March of Dimes, prematurity/low birthweight is the second most expensive condition for inpatient hospital care, with an average hospital stay of 26 days. The average cost of Medicaid services for the first four years of a very low birthweight (2.2 to 3.3 lbs.) baby’s life is $61,902 compared with $7,260 for a baby born with a normal weight, according to the Wisconsin Department of Health Services. Medicaid covers 40 percent of all births in the United States and states pay millions of dollars for the medical care of low birthweight babies.

State Actions. States have expanded access to prenatal care to mitigate factors that increase the risk of having a low birthweight baby such as tobacco, alcohol or drug use and chronic health issues:

  • The Colorado Prenatal Plus program provides additional services—such as case management, support to quit smoking and mental health counseling—to high‐risk pregnant women enrolled in Medicaid, saving $1,138 in Medicaid costs per mother and baby compared with a similar high‐risk group that did not receive services, according to a study in 2002.
  • Virginia’s Partners in Pregnancy program provides additional care to high‐risk women enrolled in an Optima Health plan, including women enrolled in Medicaid. Services include assigning them a “medical home,” and providing home visits and case management by nurses and outreach workers. Mothers and newborns in the program—during pregnancy and through the infant’s first year of life—required an average of $2,287 less in medical care than similar women not enrolled.
  • In 2011, Tennessee lawmakers enacted Senate Bill 616 (2011 Tenn. Pub. Acts, Chap. 331), which encouraged the state’s Medicaid program to improve newborn health, reduce costs and increase the quality of care with guidance from the Centers for Medicare and Medicaid Services’ Neonatal Outcomes Improvement Project.

Sources: Centers for Disease Control and Prevention, 2008; Association of Maternal and Child Health Programs Innovation Station, 2011; National Conference of State Legislatures, 2011.

United States map of Low Birthweight Births, 2008

















Source: Centers for Disease Control and Prevention, National Center for Health Statistics, final natality data.
Retrieved July 22, 2011 from March of Dimes, Peristats, http://www.marchofdimes.com/peristats.


Average Hospital Cost for Full Term/Normal Birthweight and Preterm/low birthweight Births, 2009 bar chart
















Note: Costs are for the entire hospital stay and are not specific to a diagnosis or procedure.

Source: HCUPnet. Healthcare Cost and Utilization Project (HCUP). 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://hcupnet.ahrq.gov/ Accessed August 11, 2011.


Additional Resources

Investing in Healthy Babies
NCSL LegisBrief, March 2009

Low Birthweight
March of Dimes

Data Book for Policy Makers: Maternal, Infant, and Child Health in the United States, 2010
March of Dimes

Premature Birth
Centers for Disease Control and Prevention

FastStats: Birthweight and Gestation
Centers for Disease Control and Prevention

Are Preterm Births on the Decline in the United States? Recent Data From the National Vital Statistics System
National Center for Health Statistics, Centers for Disease Control and Prevention, May 2010

Born a Bit Too Early: Recent Trends in Late Preterm Births
National Center for Health Statistics, Centers for Disease Control and Prevention, November 2009

Delivering Healthier Babies and Economic Returns
Partnership for America's Economic Success, December 2009