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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Short and long-term costs among women experiencing preterm labour or preterm birth: the German experience

Authors: Shibani Pokras, Jeanne Pimenta, Evie Merinopoulou, Dimitra Lambrelli

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

Preterm labour and birth (PTL/PTB) is characterised by major health and developmental risks for children, life–changing consequences for their families, and substantial healthcare and economic challenges for wider society. While it is known that PTL/PTB impacts infant healthcare costs in the short and long term in Germany, maternal costs have not been described in detail. The aim of this study was to comprehensively describe costs and resource use among PTL/PTB mothers during pregnancy, at hospitalisation for delivery, and up to three years after delivery—overall and according to gestational age (GA) at delivery.

Methods

This study used data from the Statutory Health Insurance (SHI) sample of the AOK Hessen database in Germany. Mothers aged 12–44 years with deliveries between 2009 and 2013 and > 9 months of medical history prior to delivery were included. PTL/PTB mothers were defined by an International Classification of Diseases, 10th Revision (ICD-10) code for PTL during pregnancy, a diagnosis-related group (DRG) code indicating birthweight < 2500 g, or delivery of an infant < 37 weeks GA. Inpatient and outpatient resource use and total direct medical costs were examined during pregnancy, at delivery hospitalisation, and up to three years post-delivery.

Results

Of all mothers, 2147 (20%) experienced PTL/PTB. During pregnancy, median costs for PTL/PTB mothers were €2130. During delivery hospitalisation, the mean length of stay for all PTL/PTB mothers was 6.0 days, and median costs were €2037. Length of stay and costs declined with increasing GA. Long term, PTL/PTB mothers’ total median costs were €607 in Year 1, €332 in Year 2, and €388 in Year 3 post-delivery. In each year after delivery, median costs appeared to be greater for mothers who delivered at lower GAs.

Conclusion

In this description of costs and resource use among PTL/PTB mothers in Germany throughout the pregnancy and up to three years after delivery, the greatest costs were noted prior to delivery. Costs appeared to decrease with increasing GA, particularly during the delivery hospitalisation and the first year after delivery.
Appendix
Available only for authorised users
Footnotes
1
Linkage between mothers and infants in AOK Hessen is not possible if the mother or the infant (or both) are not insured with the AOK, or if the mother or infant have not been included in the randomly selected SHI sample. This meant that, in total, linkage to infants was only possible for 16.3% of all mothers in the dataset.
 
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Metadata
Title
Short and long-term costs among women experiencing preterm labour or preterm birth: the German experience
Authors
Shibani Pokras
Jeanne Pimenta
Evie Merinopoulou
Dimitra Lambrelli
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1912-0

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