TY - JOUR
T1 - Obesity in pregnancy
T2 - Infant health service utilisation and costs on the NHS
AU - Morgan, Kelly L.
AU - Rahman, Muhammad A.
AU - Hill, Rebecca A.
AU - Khanom, Ashrafunnesa
AU - Lyons, Ronan A.
AU - Brophy, Sinead T.
PY - 2015/11/26
Y1 - 2015/11/26
N2 - Objective: To estimate the direct healthcare cost of infants born to overweight or obese mothers to the National Health Service in the UK. Design: Retrospective prevalence-based study. Setting: Combined linked anonymised electronic data sets on a cohort of mother-child pairs enrolled on the Growing Up in Wales: Environments for Healthy Living (EHL) study. Infants were categorised according to maternal early-pregnancy body mass index (BMI): healthy weight mother (18.5≤BMI<25 kg/m2; n=342), overweight mother (25≤BMI≤29.9 kg/m2; n=157) and obese mother (BMI≥30; n=110). Participants: 609 singleton pregnancies with available health service records and an antenatal maternal BMI. Primary outcome measure: Total health service utilisation and direct healthcare costs for providing these services in the year 2012-2013. Costs are calculated as cost of the infant (no maternal costs considered) and are related to health service usage from birth to age 1 year. Results: A strong association existed between healthcare usage cost and BMI ( p<0.001). Mean total costs were 72% higher among children born to obese mothers (rate ratio (RR) 1.72, 95% CI 1.71 to 1.73) compared with infants born to healthy weight mothers. Higher costings were attributed to a significantly greater number (RR 1.39, 95% CI 1.04 to 1.84) and duration (RR 1.55, 95% CI 1.37 to 1.74) of inpatient visits and a higher number of general practitioner visits (RR 1.10, 95% CI 1.03 to 1.16). Total mean additional resource cost was estimated at £65.13 for infants born to overweight mothers and £1138.11 for infants born to obese mothers, when compared with infants of healthy weight mothers. Conclusions: Increasingly infants born to mothers with high BMIs consume additional health service resources in the first year of life; this was apparent across inpatient and general practitioner services. Considering both maternal and infant health service use, interventions that cost less than £2310 per person in reducing obesity early pregnancy could be cost-effective.
AB - Objective: To estimate the direct healthcare cost of infants born to overweight or obese mothers to the National Health Service in the UK. Design: Retrospective prevalence-based study. Setting: Combined linked anonymised electronic data sets on a cohort of mother-child pairs enrolled on the Growing Up in Wales: Environments for Healthy Living (EHL) study. Infants were categorised according to maternal early-pregnancy body mass index (BMI): healthy weight mother (18.5≤BMI<25 kg/m2; n=342), overweight mother (25≤BMI≤29.9 kg/m2; n=157) and obese mother (BMI≥30; n=110). Participants: 609 singleton pregnancies with available health service records and an antenatal maternal BMI. Primary outcome measure: Total health service utilisation and direct healthcare costs for providing these services in the year 2012-2013. Costs are calculated as cost of the infant (no maternal costs considered) and are related to health service usage from birth to age 1 year. Results: A strong association existed between healthcare usage cost and BMI ( p<0.001). Mean total costs were 72% higher among children born to obese mothers (rate ratio (RR) 1.72, 95% CI 1.71 to 1.73) compared with infants born to healthy weight mothers. Higher costings were attributed to a significantly greater number (RR 1.39, 95% CI 1.04 to 1.84) and duration (RR 1.55, 95% CI 1.37 to 1.74) of inpatient visits and a higher number of general practitioner visits (RR 1.10, 95% CI 1.03 to 1.16). Total mean additional resource cost was estimated at £65.13 for infants born to overweight mothers and £1138.11 for infants born to obese mothers, when compared with infants of healthy weight mothers. Conclusions: Increasingly infants born to mothers with high BMIs consume additional health service resources in the first year of life; this was apparent across inpatient and general practitioner services. Considering both maternal and infant health service use, interventions that cost less than £2310 per person in reducing obesity early pregnancy could be cost-effective.
UR - http://www.scopus.com/inward/record.url?scp=84970928417&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2015-008357
DO - 10.1136/bmjopen-2015-008357
M3 - Article
C2 - 26526808
AN - SCOPUS:84970928417
VL - 5
JO - BMJ open
JF - BMJ open
IS - 11
M1 - e008357
ER -
