Short-term costs of preeclampsia to the United States health care system

Am J Obstet Gynecol. 2017 Sep;217(3):237-248.e16. doi: 10.1016/j.ajog.2017.04.032. Epub 2017 Jul 11.

Abstract

Background: Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States.

Objective: This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012.

Study design: We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population-based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set.

Results: Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P < .001). Overall, the total cost burden of preeclampsia during the first 12 months after birth was $1.03 billion for mothers and $1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from $150,000 at 26 weeks gestational age to $1311 at 36 weeks gestational age.

Conclusion: In 2012, the cost of preeclampsia within the first 12 months of delivery was $2.18 billion in the United States ($1.03 billion for mothers and $1.15 billion for infants), and was disproportionately borne by births of low gestational age.

Keywords: health care cost burden; hospital admission; maternal morbidity; maternal mortality; perinatal morbidity; preeclampsia; preterm birth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bronchopulmonary Dysplasia / economics
  • Bronchopulmonary Dysplasia / epidemiology
  • Cerebral Hemorrhage / economics
  • Cerebral Hemorrhage / epidemiology
  • Cohort Studies
  • Female
  • Fetal Distress / economics
  • Fetal Distress / epidemiology
  • Gestational Age
  • Health Care Costs*
  • Humans
  • Infant
  • Infant, Newborn
  • Leukomalacia, Periventricular / economics
  • Leukomalacia, Periventricular / epidemiology
  • Male
  • Middle Aged
  • Postpartum Hemorrhage / economics
  • Postpartum Hemorrhage / epidemiology
  • Pre-Eclampsia / economics*
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Regression Analysis
  • Respiratory Distress Syndrome, Newborn / economics
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Retrospective Studies
  • Seizures / economics
  • Seizures / epidemiology
  • Sepsis / economics
  • Sepsis / epidemiology
  • Thrombocytopenia / economics
  • Thrombocytopenia / epidemiology
  • United States / epidemiology
  • Young Adult