title: The Additional Cost Burden of Preexisting Medical Conditions During Pregnancy and Childbirth.
abstract: OBJECTIVE
  To identify the prevalence of comorbidities in pregnant women and examine the incremental costs of these conditions on the care for mothers and their newborns.
  
  
  METHODS
  This was a retrospective comparative cohort study of women ages 15-49 years with a documented live-birth delivery using de-identified claims from the MarketScan Research Commercial Claims and Encounters database incurred between January 1, 2007, and December 31, 2011. Total health care costs from date of first pregnancy-related claim through 3 months postdelivery were reported; pregnancy-related comorbidities prior to the pregnancy diagnosis were identified and categorized in the 12 months prior to the pregnancy diagnosis, and costs associated with each condition were compiled. A subset of newborns was matched to their mothers using a unique family identifier and their costs were captured for the three months following birth. Comparisons of costs for both mothers and newborns were made using both unadjusted and multivariate analyses between mothers with and without each condition.
  
  
  RESULTS
  A total of 322,141 women with live births were identified; 135,572 of these mothers were linked to their newborn(s). Prevalent conditions included back disorders (8.9%), mental disorders (6.5%), headache (5.5%), allergic rhinitis (5.5%), and osteoarthritis (4.8%). Diabetes (0.97%) and hypertension (1.9%) were associated with the highest adjusted incremental costs of care in both mothers ($6,211 [95% confidence interval 5,720-6,702] and $3,367 [95% CI 2,935-3,799] respectively) and newborns ($2,067 [95% CI 1,515-2618]; and $1,210 [95% CI 725-1,695] respectively). The two most common conditions, back disorders and mental disorders, were associated with unadjusted costs of $1,895/$978 (mothers/infants) and $2,097/$1,902 (mothers/infants) respectively.
  
  
  CONCLUSIONS
  Preexisting conditions common in pregnant women may result in additional resource utilization and costs for both mothers and newborns.
authors.affiliation: 1 Bayer HealthCare Pharmaceuticals , Whippany, New Jersey.
authors.forename: Amy
authors.initials: A
authors.lastname: Law
authors.affiliation: 1 Bayer HealthCare Pharmaceuticals , Whippany, New Jersey.
authors.forename: Mark
authors.initials: M
authors.lastname: McCoy
authors.affiliation: 1 Bayer HealthCare Pharmaceuticals , Whippany, New Jersey.
authors.forename: Richard
authors.initials: R
authors.lastname: Lynen
authors.affiliation: 2 Truven Health Analytics , Bethesda, Maryland.|3 Present address: Truven Health Analytics , Bend, Oregon.
authors.forename: Suellen M
authors.initials: SM
authors.lastname: Curkendall
authors.affiliation: 2 Truven Health Analytics , Bethesda, Maryland.|4 Present address: Department of Clinical Pharmacy, University of Tennessee Health Science Center College of Pharmacy , Memphis, Tennessee.
authors.forename: Justin
authors.initials: J
authors.lastname: Gatwood
authors.affiliation: 2 Truven Health Analytics , Bethesda, Maryland.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Juneau
authors.affiliation: 2 Truven Health Analytics , Bethesda, Maryland.|5 Present address: AmerisourceBergen , Palm Harbor, Florida.
authors.forename: Pamela
authors.initials: P
authors.lastname: Landsman-Blumberg
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult