Preeclampsia: New study documents its enormous economic and health burden

July 11, 2017

Philadelphia, PA, July 11, 2017 - Preeclampsia, a dangerous condition that may occur during pregnancy, can lead to serious complications for both mother and baby. Driven in part by older maternal age and greater obesity, rates of preeclampsia are rising rapidly, yet surprisingly there are few national estimates of the health and economic impact of preeclampsia on mothers and their infants. A new study in the American Journal of Obstetrics and Gynecology (AJOG) provides sobering data on this topic by examining the short-term costs associated with the condition. Significantly increasing the chance of adverse health outcomes, preeclampsia accounts for over $2.18 billion of health care expenditure in the first 12 months after birth.

The findings of this study are particularly important given the recent rise in preeclampsia cases. Since 1980, cases have increased steadily from 2.4% of pregnancies to 3.8% in 2010. "Existing treatment options for preeclampsia and research into the disease have been limited despite the scale of the disease burden and its high growth rate. From an epidemiologic perspective, preeclampsia is growing at a rate more rapid than diabetes, heart disease, Alzheimer's disease, obesity, and chronic kidney disease -- diseases for which substantial research and treatment funding have been allocated," explained senior investigator Anupam B. Jena, MD, PhD, Ruth L. Newhouse Associate Professor, Department of Health Care Policy, Harvard Medical School, and Massachusetts General Hospital, Boston, MA. "This is notable as the rate of growth of early-onset preeclampsia in the U.S. has recently exceeded the rate in other high-income countries, as well as several low- and middle-income countries."

Roberto Romero, MD, DMedSci., Editor-in-Chief for Obstetrics of AJOG and Chief of the Perinatology Research Branch of NICHD/NIH, stated that preeclampsia is a leading cause of maternal death and perinatal morbidity and mortality. However, policymakers, scientific administrators, patients, and physicians have not had a national estimate of the health care burden and costs of preeclampsia. The article by Jena and colleagues provides important new information and this is why AJOG has selected this article as a Report of Major Impact. Dr. Romero emphasized that the cost of preeclampsia goes beyond the short-term health care expenditures as women affected by this disorder are at an increased risk for early onset cardiovascular diseases, such as heart attacks and hypertension, years and decades after delivery. Moreover, their infants are also at risk for adverse health events due to preeclampsia and preterm birth during childhood and beyond. Therefore, the $2.18 billion health care expenditures in the first 12 months after birth is a minimum estimate of the real financial toll imposed by preeclampsia.

Combining information from multiple U.S. data sources, researchers found that mothers with preeclampsia and their infants were at a significantly increased risk for adverse health events compared to mothers without preeclampsia (increased 4.6% to 10.1% in mothers and 7.8% to 15.4% in infants within 12 months of childbirth). For mothers, the most common preeclampsia-related problems were hemorrhage (3.1% to 5.4%) and thrombocytopenia, low blood platelet count (0.9% to 3.7%). For infants, preeclampsia was most closely related to an increased risk for respiratory distress syndrome (1.9% to 6.6%) and sepsis (3.0% to 5.4%). Longer term adverse outcomes associated with preeclampsia have been demonstrated, for example, preeclampsia has been associated with an increased risk of cardiovascular disease.

In addition, researchers found the average gestational age was reduced by 1.7 weeks in preeclampsia cases. Preterm birth not only puts newborns at risk, but also increases health care spending. The data revealed substantially higher costs associated with preeclampsia births. During the first 12 months of life, the overall burden of preeclampsia was $1.03 billion for mothers and $1.15 billion for infants. To put these figures in context, this amount of health care spending represents one third of the total cost of obstetric care for preeclampsia pregnancies in the U.S. Much of the cost for infants was determined by gestational age, ranging from $282,570 at less than 28 weeks to as little as $6,013 at 37 or more weeks.

In the accompanying editorial, William Callaghan, MD, chief, Maternal and Infant Health Branch, Centers for Disease Control and Prevention, Atlanta, GA, and co-authors cite the research done by Dr. Jena and his co-investigators as an important step towards a better understanding of this condition and its implications for the health care landscape.

"Rising rates of preeclampsia threaten the health and well-being of mothers and babies," commented Dr. Callaghan. "Although preeclampsia has affected pregnant women for millennia, there is still much we do not know. This new research underscores the urgent need to continue research into its causes and to implement strategies that may help women manage this condition."

"Total short-term health care costs for preeclampsia pregnancies, including the usual costs associated with birth, were estimated to be $6.4 billion, summed across mothers and infants for all gestational ages in the U.S.," said Eleni Tsigas, Executive Director of the Preeclampsia Foundation. "At $2.18 billion, the burden of preeclampsia represents a significant one third of that total short-term cost, and that's an important call-to-action for more research funding and awareness of this major health problem."

Quantifying the total cost of a health problem helps to show the public, payers, and health care administrators the magnitude of the problem on a population level. By underscoring the economic burden of preeclampsia, this study has provided important information about the high costs of this condition. It serves as a stark reminder that research efforts must be continued in order to understand the etiology, prediction, and treatment of a condition that is among the biggest challenges in maternity care today.


Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to