A study recently published in Ultrasound Obstetrics & Gynecology highlights the lasting healthcare burden and costs associated with hemolytic disease of the fetus and newborn (HDFN), particularly in children who require intensive treatments such as intrauterine transfusions (IUT) or postnatal blood transfusions.
To evaluate healthcare utilization and direct costs for children affected by the condition, researchers from Sweden analyzed national health registers spanning from 2000 to 2021. The study authors identified 7,289 infants with HDFN, of whom 1,950 (27%) required treatment. These included 149 who underwent intrauterine transfusion, 517 treated with postnatal transfusions and 1,284 who received phototherapy.
The findings showed that children with HDFN needed substantially more hospital care in their first year of life compared with those without the condition. Among treated infants, hospitalization rates were highest in the transfusion group (92%), followed by phototherapy (88%) and intrauterine transfusion (83%), compared with just 22% in the non-HDFN group.
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Infants who required transfusion spent an average of nearly 25 days in hospital in their first year, while those treated with intrauterine transfusion averaged 22 days. In contrast, those who received only phototherapy spent about 11 days in hospital, and those without HDFN averaged 13 days.
Inpatient costs mirrored this trend. Children who underwent intrauterine or postnatal transfusions had the highest first-year costs, while those with phototherapy or no HDFN incurred far lower expenses.
Importantly, the study found that increased healthcare use and costs did not end after infancy. For children treated with transfusions, both remained elevated for up to four years after birth, suggesting a prolonged healthcare burden into the preschool years.
The study authors concluded that HDFN requiring transfusion is associated with significantly higher hospitalisations, longer stays and sustained costs, underscoring the need for strategies to reduce disease severity and its long-term impact.
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