title: Maternal asthma, diabetes, and high blood pressure are associated with low birth weight and increased hospital birth and delivery charges; Hawai'i hospital discharge data 2003-2008.
abstract: Asthma, diabetes, and high blood pressure are common maternal conditions that can impact birth outcomes. Data from hospital discharges in Hawai'i were analyzed for 107,034 singleton births from 2003-2008. Categories were determined using the International Statistical Classification of Diseases, ninth revision (ICD-9) from linked delivery records of mother and infant. Prevalence estimates of asthma (ICD-9: 493), diabetes (ICD-9: 250,648.0, 648.8), high blood pressure (ICD-9: 401-405,642) as coded on the delivery record, low birth weight (<2500 grams), high birth weight (>4500 grams), Cesarean delivery, and median hospital charges were calculated. Median regression analysis assessed total hospital charges adjusting for maternal age, maternal race, insurance, and Cesarean delivery. Maternal asthma was present in 4.3% (95% confidence interval=4.1-4.4%), maternal diabetes was present in 7.7% (95% CI=7.6-7.9%), and maternal high blood pressure was present in 9.2% (95% CI=9.0-9.3%) of births. In the adjusted median regression analysis, mothers with asthma had $999 (95% CI: $886 to $1,112) higher hospital charges compared to those without; mothers with diabetes had $743 (95% CI: $636 to $850) higher charges compared to those without; and mothers with high blood pressure had $2,314 (95% CI: $2,194 to $2,434) higher charges compared to those without. Asthma, diabetes, and high blood pressure are associated with higher hospital delivery charges and low birth weight. Diabetes and high blood pressure were also associated with Cesarean delivery. An increased awareness of the impact of these conditions on both adverse birth outcomes and the development of chronic disease is needed.
authors.affiliation: Hawai'i Department of Health, Honolulu, HI (DKH, DWF, LJF).
authors.forename: Donald K
authors.initials: DK
authors.lastname: Hayes
authors.affiliation: Hawai'i Department of Health, Honolulu, HI (DKH, DWF, LJF).
authors.forename: David W
authors.initials: DW
authors.lastname: Feigal
authors.affiliation: Hawai'i Department of Health, Honolulu, HI (DKH, DWF, LJF).
authors.forename: Ruben A
authors.initials: RA
authors.lastname: Smith
authors.affiliation: Hawai'i Department of Health, Honolulu, HI (DKH, DWF, LJF).
authors.forename: Loretta J
authors.initials: LJ
authors.lastname: Fuddy
mesh_terms: D000328:Adult; D001249:Asthma / Q000191:economics / Q000453:epidemiology*; D036861:Delivery, Obstetric / Q000191:economics / Q000639:trends*; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D017721:Hospital Costs / Q000639:trends*; D006801:Humans; D006973:Hypertension / Q000191:economics / Q000453:epidemiology*; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Birth Outcomes; Chronic Conditions; Hospital Charges; Reproductive Health