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

• Published in: American journal of obstetrics and gynecology Vol. 217; no. 3; pp. 237 - 248.e16
• Main Authors: Stevens, Warren, Shih, Tiffany, Incerti, Devin, Ton, Thanh G.N., Lee, Henry C., Peneva, Desi, Macones, George A., Sibai, Baha M., Jena, Anupam B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2017
• Subjects: 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 cost burden; Health Care Costs; hospital admission; Humans; Infant; Infant, Newborn; Leukomalacia, Periventricular - economics; Leukomalacia, Periventricular - epidemiology; Male; maternal morbidity; maternal mortality; Middle Aged; perinatal morbidity; Postpartum Hemorrhage - economics; Postpartum Hemorrhage - epidemiology; Pre-Eclampsia - economics; Pre-Eclampsia - epidemiology; preeclampsia; Pregnancy; preterm birth; 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; health care cost burden; preterm birth; hospital admission; maternal morbidity; perinatal morbidity; preeclampsia; maternal mortality
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2017.04.032

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.
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.
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.
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.
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.