Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 4

Category: Healthcare Policy/Economics

Poster Session 4

(1023) Betamethasone administration among neonates at 22 weeks gestational age: a cost-effectiveness analysis

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Amanda M. Baucom, MBA, MD (she/her/hers)

Maternal Fetal Medicine Fellow
University of Cincinnati
Cincinnati, Ohio, United States

Coauthor(s)

Robert M. Rossi, MD

Assistant Professor
Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
Aaron B. Caughey, MD, PhD

Chair and Professor of Obstetrics and Gynecology
Oregon Health & Science University
Oregon Health & Science University, Oregon, United States
ME

Mark H. Eckman, MD, MS

Emeritus, Department of Internal Medicine
University of Cincinnati College of Medicine
University of Cincinnati College of Medicine, Ohio, United States

Objective:
The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) have updated guidelines to recommend considering the initiation of betamethasone at 22 weeks' gestation. While previous studies have assessed the cost-effectiveness of resuscitation methods at 22 weeks, the long-term impact of betamethasone administration on neurological outcomes and survival from a cost-effectiveness perspective remains unknown. This study aims to evaluate the cost-effectiveness of initiating betamethasone at 22 weeks gestation, focusing on its influence on long-term neurological outcomes and survival.

Study Design:
A decision-analytic model was developed using TreeAge software to compare survival rates and neurological outcomes in infants born at 22 weeks’ gestation, with and without the administration of betamethasone. Given that approximately 0.05% of deliveries in the United States occur at 22 weeks annually, the analysis was applied to a theoretical cohort of 1,693 pregnant individuals. Costs were evaluated in 2025 U.S. dollars over a lifetime horizon, with effectiveness measured in neonatal and maternal quality-adjusted life years (QALYs). Cost and utility values were derived from published literature. The incremental cost-effectiveness ratio (ICER) was calculated as cost per QALY, using a willingness-to-pay threshold of $100,000 per QALY.

Results:
In this modeled cohort, antenatal betamethasone administration resulted in an increase of 343 additional survivors. Among these, 289 infants survived with mild or no neurological impairment. In contrast, withholding betamethasone led to 300 survivors, and only 135 with mild or no neurological impairment. Overall, betamethasone administration provided an additional 2.92 QALYs per neonate compared to no administration. The total costs were $389,642,460 more with a difference of 4,961 QALYs. The ICER was 78,684, which was cost effective.

Conclusion:
In this theoretical model, antenatal betamethasone administration for infants born at 22 weeks’ gestation was found to be cost-effective compared to no administration.