PP19 Estimating the cost of pre-eclampsia in the health system: a cross sectional analysis using screening for pregnancy endpoints (scope) study

Abstract

BackgroundPre-Eclampsia is a multisystem disorder, which can affect both mother and child. It can lead to the development of long term morbidities such as chronic hypertension, increase the risk of hospitalisation and also accounts for a substantial proportion of maternal mortality. The only treatment for pre-eclampsia is delivery which involves increased monitoring during pregnancy. This has substantial health service use implications. However, to date, there has been minimal research examining health service use associated with pre-eclampsia.The aim is to compare health service use among women with and without pre-eclampsia using data from the Screening for Pregnancy Endpoints Study (SCOPE), an international multi-centre prospective study.MethodsCross-sectional analysis of data from the SCOPE study was conducted. SCOPE participants were healthy, nulliparous women with singleton pregnancies recruited between November 2004 and February 2011 in Cork, Ireland (n = 1774). Data were extracted on women with pre-eclampsia (n = 68), and a 10% random sample of women without pre-eclampsia (n = 171). Health service use indicators were divided into antenatal, perinatal and post-natal. Antenatal health service use included number of hospital visits, any hospital admissions, and number of scans. Perinatal indicators included maternal and infant length of hospital stay post-delivery, type of delivery, whether the mother was induced, if an episiotomy or an epidural was performed. Postpartum included admissions of the infant the Neonatal Intensive Care Unit (NICU).ResultsPreliminary results suggest that 44% (n = 30, 95% CI 32–56%]) of women with pre-eclampsia had a caesarean section compared to 25% (n = 43, 95% CI 19–32%]) of women without pre-eclampsia. Furthermore women with pre-eclampsia had longer average length of hospital stay with 24% (n = 16, 95% CI 13–34%]) staying an average of more than five days post-partum compared to 5% (n = 9, 95% CI 2–9%]) of women without pre-eclampsia. 28% (n = 19, 95% CI 17–39%]) of infants born to mothers with pre-eclampsia were admitted to the NICU compared to 9% (n = 16, 95% CI 5–14%]) of infants born to mothers without pre-eclampsia.ConclusionPreliminary results suggest increased obstetric intervention and health service use among women with pre-eclampsia which had resource implications for the health service. The results of this study will be used to estimate the direct health service costs of pre-eclampsia in the absence of current international data.