Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study

F C Denison; P Norwood; S Bhattacharya; A Duffy; T Mahmood; C Morris; E A Raja; J E Norman; A J Lee; G Scotland

doi:10.1111/1471-0528.12443

Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study

F C Denison, P Norwood, S Bhattacharya, A Duffy, T Mahmood, C Morris, E A Raja, J E Norman, A J Lee, G Scotland

Research output: Contribution to journal › Article (Academic Journal) › peer-review

91 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the impact of maternal body mass index (BMI, kg/m(2)) on clinical complications, inpatient admissions, and additional short-term costs to the National Health Service (NHS) in Scotland.

DESIGN: Retrospective cohort study using an unselected population database.

SETTING: Obstetric units in Scotland, 2003-2010.

POPULATION: A total of 124,280 singleton deliveries in 109,592 women with a maternal BMI recorded prior to 16 weeks of gestation.

METHODS: Population-based retrospective cohort study of singleton deliveries, with multivariable analysis used to assess short-term morbidity and health service costs.

MAIN OUTCOME MEASURES: Maternal and offspring outcomes, number and duration of hospital admissions, and healthcare costs.

RESULTS: Using multivariable analysis, in comparison with women of normal weight, women who were overweight, obese, or severely obese had an increased risk of essential hypertension [1.87 (1.18-2.96), 11.90 (7.18-19.72), and 36.10 (18.33-71.10)], pregnancy-induced hypertension [1.76 (1.60-1.95), 2.98 (2.65-3.36), and 4.48 (3.57-5.63)], gestational diabetes [3.39 (2.30-4.99), 11.90 (7.54-18.79), and 67.40 (37.84-120.03)], emergency caesarean section [1.94 (1.71-2.21), 3.40 (2.91-3.96), and 14.34 (9.38-21.94)], and elective caesarean section [2.06 (1.84-2.30), 4.61 (4.06-5.24), and 17.92 (13.20-24.34)]. Compared with women of normal weight, women who were underweight, overweight, obese, or severely obese were associated with an 8, 16, 45, and 88% increase in the number of admissions, respectively, and women who were overweight, obese, or severely obese were associated with a 4, 9, and 12% increase in the duration of stay (all P < 0.001). The additional maternity costs [mean (95% CI), adjusted analyses] for women who were underweight, overweight, obese, or severely obese were £102.27 (£48.49-156.06), £59.89 (£41.61-78.17), £202.46 (£178.61-226.31), and £350.75 (£284.82-416.69), respectively.

CONCLUSIONS: Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.

Original language	English
Pages (from-to)	72-81; discussion 82
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	121
Issue number	1
DOIs	https://doi.org/10.1111/1471-0528.12443
Publication status	Published - Jan 2014

Bibliographical note

Keywords

Adult
Body Mass Index
Cesarean Section/economics
Cohort Studies
Diabetes, Gestational/economics
Female
Health Care Costs
Humans
Hypertension/economics
Hypertension, Pregnancy-Induced/economics
Ideal Body Weight
Length of Stay/economics
Maternal Health Services/economics
Multivariate Analysis
Obesity/economics
Overweight/economics
Pregnancy
Pregnancy Complications/economics
Retrospective Studies
Scotland
State Medicine/economics
Thinness/economics
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Denison, F. C., Norwood, P., Bhattacharya, S., Duffy, A., Mahmood, T., Morris, C., Raja, E. A., Norman, J. E., Lee, A. J., & Scotland, G. (2014). Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. BJOG: An International Journal of Obstetrics and Gynaecology, 121(1), 72-81; discussion 82. https://doi.org/10.1111/1471-0528.12443

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abstract = "OBJECTIVE: To investigate the impact of maternal body mass index (BMI, kg/m(2)) on clinical complications, inpatient admissions, and additional short-term costs to the National Health Service (NHS) in Scotland.DESIGN: Retrospective cohort study using an unselected population database.SETTING: Obstetric units in Scotland, 2003-2010.POPULATION: A total of 124,280 singleton deliveries in 109,592 women with a maternal BMI recorded prior to 16 weeks of gestation.METHODS: Population-based retrospective cohort study of singleton deliveries, with multivariable analysis used to assess short-term morbidity and health service costs.MAIN OUTCOME MEASURES: Maternal and offspring outcomes, number and duration of hospital admissions, and healthcare costs.RESULTS: Using multivariable analysis, in comparison with women of normal weight, women who were overweight, obese, or severely obese had an increased risk of essential hypertension [1.87 (1.18-2.96), 11.90 (7.18-19.72), and 36.10 (18.33-71.10)], pregnancy-induced hypertension [1.76 (1.60-1.95), 2.98 (2.65-3.36), and 4.48 (3.57-5.63)], gestational diabetes [3.39 (2.30-4.99), 11.90 (7.54-18.79), and 67.40 (37.84-120.03)], emergency caesarean section [1.94 (1.71-2.21), 3.40 (2.91-3.96), and 14.34 (9.38-21.94)], and elective caesarean section [2.06 (1.84-2.30), 4.61 (4.06-5.24), and 17.92 (13.20-24.34)]. Compared with women of normal weight, women who were underweight, overweight, obese, or severely obese were associated with an 8, 16, 45, and 88% increase in the number of admissions, respectively, and women who were overweight, obese, or severely obese were associated with a 4, 9, and 12% increase in the duration of stay (all P < 0.001). The additional maternity costs [mean (95% CI), adjusted analyses] for women who were underweight, overweight, obese, or severely obese were £102.27 (£48.49-156.06), £59.89 (£41.61-78.17), £202.46 (£178.61-226.31), and £350.75 (£284.82-416.69), respectively.CONCLUSIONS: Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.",

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author = "Denison, {F C} and P Norwood and S Bhattacharya and A Duffy and T Mahmood and C Morris and Raja, {E A} and Norman, {J E} and Lee, {A J} and G Scotland",

note = "{\textcopyright} 2013 Royal College of Obstetricians and Gynaecologists.",

year = "2014",

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doi = "10.1111/1471-0528.12443",

language = "English",

volume = "121",

pages = "72--81; discussion 82",

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Denison, FC, Norwood, P, Bhattacharya, S, Duffy, A, Mahmood, T, Morris, C, Raja, EA, Norman, JE, Lee, AJ & Scotland, G 2014, 'Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 121, no. 1, pp. 72-81; discussion 82. https://doi.org/10.1111/1471-0528.12443

Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. / Denison, F C; Norwood, P; Bhattacharya, S et al.
In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 121, No. 1, 01.2014, p. 72-81; discussion 82.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs

T2 - a population-based study

AU - Denison, F C

AU - Norwood, P

AU - Bhattacharya, S

AU - Duffy, A

AU - Mahmood, T

AU - Morris, C

AU - Raja, E A

AU - Norman, J E

AU - Lee, A J

AU - Scotland, G

PY - 2014/1

Y1 - 2014/1

N2 - OBJECTIVE: To investigate the impact of maternal body mass index (BMI, kg/m(2)) on clinical complications, inpatient admissions, and additional short-term costs to the National Health Service (NHS) in Scotland.DESIGN: Retrospective cohort study using an unselected population database.SETTING: Obstetric units in Scotland, 2003-2010.POPULATION: A total of 124,280 singleton deliveries in 109,592 women with a maternal BMI recorded prior to 16 weeks of gestation.METHODS: Population-based retrospective cohort study of singleton deliveries, with multivariable analysis used to assess short-term morbidity and health service costs.MAIN OUTCOME MEASURES: Maternal and offspring outcomes, number and duration of hospital admissions, and healthcare costs.RESULTS: Using multivariable analysis, in comparison with women of normal weight, women who were overweight, obese, or severely obese had an increased risk of essential hypertension [1.87 (1.18-2.96), 11.90 (7.18-19.72), and 36.10 (18.33-71.10)], pregnancy-induced hypertension [1.76 (1.60-1.95), 2.98 (2.65-3.36), and 4.48 (3.57-5.63)], gestational diabetes [3.39 (2.30-4.99), 11.90 (7.54-18.79), and 67.40 (37.84-120.03)], emergency caesarean section [1.94 (1.71-2.21), 3.40 (2.91-3.96), and 14.34 (9.38-21.94)], and elective caesarean section [2.06 (1.84-2.30), 4.61 (4.06-5.24), and 17.92 (13.20-24.34)]. Compared with women of normal weight, women who were underweight, overweight, obese, or severely obese were associated with an 8, 16, 45, and 88% increase in the number of admissions, respectively, and women who were overweight, obese, or severely obese were associated with a 4, 9, and 12% increase in the duration of stay (all P < 0.001). The additional maternity costs [mean (95% CI), adjusted analyses] for women who were underweight, overweight, obese, or severely obese were £102.27 (£48.49-156.06), £59.89 (£41.61-78.17), £202.46 (£178.61-226.31), and £350.75 (£284.82-416.69), respectively.CONCLUSIONS: Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.

AB - OBJECTIVE: To investigate the impact of maternal body mass index (BMI, kg/m(2)) on clinical complications, inpatient admissions, and additional short-term costs to the National Health Service (NHS) in Scotland.DESIGN: Retrospective cohort study using an unselected population database.SETTING: Obstetric units in Scotland, 2003-2010.POPULATION: A total of 124,280 singleton deliveries in 109,592 women with a maternal BMI recorded prior to 16 weeks of gestation.METHODS: Population-based retrospective cohort study of singleton deliveries, with multivariable analysis used to assess short-term morbidity and health service costs.MAIN OUTCOME MEASURES: Maternal and offspring outcomes, number and duration of hospital admissions, and healthcare costs.RESULTS: Using multivariable analysis, in comparison with women of normal weight, women who were overweight, obese, or severely obese had an increased risk of essential hypertension [1.87 (1.18-2.96), 11.90 (7.18-19.72), and 36.10 (18.33-71.10)], pregnancy-induced hypertension [1.76 (1.60-1.95), 2.98 (2.65-3.36), and 4.48 (3.57-5.63)], gestational diabetes [3.39 (2.30-4.99), 11.90 (7.54-18.79), and 67.40 (37.84-120.03)], emergency caesarean section [1.94 (1.71-2.21), 3.40 (2.91-3.96), and 14.34 (9.38-21.94)], and elective caesarean section [2.06 (1.84-2.30), 4.61 (4.06-5.24), and 17.92 (13.20-24.34)]. Compared with women of normal weight, women who were underweight, overweight, obese, or severely obese were associated with an 8, 16, 45, and 88% increase in the number of admissions, respectively, and women who were overweight, obese, or severely obese were associated with a 4, 9, and 12% increase in the duration of stay (all P < 0.001). The additional maternity costs [mean (95% CI), adjusted analyses] for women who were underweight, overweight, obese, or severely obese were £102.27 (£48.49-156.06), £59.89 (£41.61-78.17), £202.46 (£178.61-226.31), and £350.75 (£284.82-416.69), respectively.CONCLUSIONS: Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.

KW - Adult

KW - Body Mass Index

KW - Cesarean Section/economics

KW - Cohort Studies

KW - Diabetes, Gestational/economics

KW - Female

KW - Health Care Costs

KW - Humans

KW - Hypertension/economics

KW - Hypertension, Pregnancy-Induced/economics

KW - Ideal Body Weight

KW - Length of Stay/economics

KW - Maternal Health Services/economics

KW - Multivariate Analysis

KW - Obesity/economics

KW - Overweight/economics

KW - Pregnancy

KW - Pregnancy Complications/economics

KW - Retrospective Studies

KW - Scotland

KW - State Medicine/economics

KW - Thinness/economics

KW - Young Adult

U2 - 10.1111/1471-0528.12443

DO - 10.1111/1471-0528.12443

M3 - Article (Academic Journal)

C2 - 24102880

SN - 1470-0328

VL - 121

SP - 72-81; discussion 82

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 1

ER -

Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study

Abstract

Bibliographical note

Keywords

UN SDGs

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