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Epidemiology

Poster Session 1

(326) Postpartum Complications and Delivery Costs Associated With Births at Term in the United States

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

To assess maternal postpartum (PP) complication rates and delivery costs for individuals delivering across the spectrum of gestational age (GA) at term (37–41 weeks GA [wGA]) in the United States.

Study Design:

A population-based cohort study of the Premier Healthcare Database (Jan 2016–Sep 2021) was conducted. Eligible individuals aged 12–55 years old who had a live birth at ≥ 37 wGA were included; trends in rates of maternal PP complications and cost of care during the delivery hospitalization were examined. Severe maternal morbidity (SMM) scores were calculated using the expanded obstetric comorbidity scoring system (Leonard et al, Obstet Gynecol 2020). Maternal PP complications were a composite of sepsis, shock, acute renal failure, cardiac and thromboembolic events, acute respiratory distress, or hemorrhage. Trends by maternal age were explored.

Results:

A total of 4,470,481 term deliveries were included. Mean±SD age at delivery was 28.9±5.7 years; the obstetric comorbidity score for SMM was 11.0±15.2. U-shaped trends were observed in the frequency of complications and per-person costs for 37 to 41 wGA (Fig 1), with inflection points at 39 wGA: 4.1% of individuals delivering at 39 wGA had a complication; associated per-person costs were $7,504. Complications and costs increased after 39 wGA, with estimates highest at 41 wGA: 6.1% had a complication; per-person costs were $8,485. Compared to individuals ≤ 35 years old at delivery, costs were consistently highest across all wGA for individuals > 35 years old. PP complication frequency was consistently highest among individuals < 17 years old and lowest among individuals 17–35 years old.

Conclusion:

Late-term deliveries exhibited the highest level of patient and hospital cost burden. Individuals > 35 years old at delivery did not have the highest frequency of complications, but their cost of care was consistently the highest, suggesting perhaps more severe complications were experienced.