The prevalence of complications and healthcare costs during pregnancy

Abstract

Objective: To study the economic burden of pregnancy in the US, common complications during pregnancy, and the incremental costs attributable to these complications. Methods: A retrospective comparative cohort study was conducted of pregnant women aged 15-49 years using de-identified medical and pharmacy claims from the Truven Health MarketScan Commercial Claims and Encounters database incurred between January 1, 2007 and December 31, 2011. The total healthcare costs are reported (adjusted to 2011 dollars) from the date of the first pregnancy-related claim through to 3 months post-delivery and these costs were compared to matched controls of non-pregnant women. Pregnancy-related complications were categorized, and the incremental costs associated with each complication were estimated using multivariate analyses. Results: A total of 322,141 eligible women with live births were studied. Compared to matched controls, the average costs of care for pregnant women were nearly $13,000 higher through 3 months post-delivery. A total of 46.9% of women had at least one pre-specified pregnancy complication; the most commonly observed were fetal abnormality (24.7%) and early or threatened labor (16.3%). Multiple gestation (1.9%) resulted in the highest adjusted incremental cost ($12,212; 95% CI=11,298, 13,216); hypertension ($6152; 95% CI=5312, 6992) and diabetes ($5081; 95% CI=4244, 5918) were also among those complications that led to high incremental costs of care. Conclusion: Pregnancy and delivery are frequently compounded by complications that lead to increased costs and resource utilization.