Obesity in pregnancy: a retrospective prevalence-based study on health service utilisation and costs on the NHS.
BMJ Open
; 4(2): e003983, 2014 Feb 27.
Article
de En
| MEDLINE
| ID: mdl-24578535
ABSTRACT
OBJECTIVE:
To estimate the direct healthcare cost of being overweight or obese throughout pregnancy to the National Health Service in Wales.DESIGN:
Retrospective prevalence-based study.SETTING:
Combined linked anonymised electronic datasets gathered on a cohort of women enrolled on the Growing Up in Wales Environments for Healthy Living (EHL) study. Women were categorised into two groups normal body mass index (BMI; n=260) and overweight/obese (BMI>25; n=224).PARTICIPANTS:
484 singleton pregnancies with available health service records and an antenatal BMI. PRIMARY OUTCOMEMEASURE:
Total health service utilisation (comprising all general practitioner visits and prescribed medications, inpatient admissions and outpatient visits) and direct healthcare costs for providing these services in the year 2011-2012. Costs are calculated as cost of mother (no infant costs are included) and are related to health service usage throughout pregnancy and 2 months following delivery.RESULTS:
There was a strong association between healthcare usage cost and BMI (p<0.001). Adjusting for maternal age, parity, ethnicity and comorbidity, mean total costs were 23% higher among overweight women (rate ratios (RR) 1.23, 95% CI 1.230 to 1.233) and 37% higher among obese women (RR 1.39, 95% CI 1.38 to 1.39) compared with women with normal weight. Adjusting for smoking, consumption of alcohol, or the presence of any comorbidities did not materially affect the results. The total mean cost estimates were £3546.3 for normal weight, £4244.4 for overweight and £4717.64 for obese women.CONCLUSIONS:
Increased health service usage and healthcare costs during pregnancy are associated with increasing maternal BMI; this was apparent across all health services considered within this study. Interventions costing less than £1171.34 per person could be cost-effective if they reduce healthcare usage among obese pregnant women to levels equivalent to that of normal weight women.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Complications de la grossesse
/
Surpoids
/
Services de santé maternelle
/
Obésité
Type d'étude:
Health_economic_evaluation
/
Prevalence_studies
/
Risk_factors_studies
Limites:
Adult
/
Female
/
Humans
/
Pregnancy
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
BMJ Open
Année:
2014
Type de document:
Article
Pays d'affiliation:
Royaume-Uni