title: Analysis of hospital cost outcome of DHA-rich fish-oil supplementation in pregnancy: Evidence from a randomized controlled trial.
abstract: OBJECTIVE
  Recent research emphasized the nutritional benefits of omega-3 long chain polyunsaturated fatty acids (LCPUFAs) during pregnancy. Based on a double-blind randomised controlled trial named "DHA to Optimize Mother and Infant Outcome" (DOMInO), we examined how omega 3 DHA supplementation during pregnancy may affect pregnancy related in-patient hospital costs.
  
  
  METHODS
  We conducted an econometric analysis based on ordinary least square and quantile regressions with bootstrapped standard errors. Using these approaches, we also examined whether smoking, drinking, maternal age and BMI could influence the effect of DHA supplementation during pregnancy on hospital costs.
  
  
  RESULTS
  Our regressions showed that in-patient hospital costs could decrease by AUD92 (P<0.05) on average per singleton pregnancy when DHA supplements were consumed during pregnancy. Our regression results also showed that the cost savings to the Australian public hospital system could be between AUD15 - AUD51 million / year.
  
  
  CONCLUSIONS
  Given that a simple intervention like DHA-rich fish-oil supplementation could generate savings to the public, it may be worthwhile from a policy perspective to encourage DHA supplementation among pregnant women.
authors.affiliation: Women's and Children's Health Research Institute, North Adelaide, Australia; Global Food Studies, Faculty of the Professions, University of Adelaide, Australia. Electronic address: sharmina.ahmed@adelaide.edu.au.
authors.forename: Sharmina
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Women's and Children's Health Research Institute, North Adelaide, Australia; Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Maria
authors.initials: M
authors.lastname: Makrides
authors.affiliation: School of Economics, University of Adelaide, Adelaide, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Sim
authors.affiliation: Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia; Neonatal Services, Women's and Children's Health Network, Australia.
authors.forename: Andy
authors.initials: A
authors.lastname: McPhee
authors.affiliation: Department of Obstetrics and Gynaecology, Joondalup Health Campus, Perth, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Quinlivan
authors.affiliation: Women's and Children's Health Research Institute, North Adelaide, Australia; School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Gibson
authors.affiliation: Global Food Studies, Faculty of the Professions, University of Adelaide, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Umberger
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000191:economics; D017046:Cost Savings; D003365:Costs and Cost Analysis; D019587:Dietary Supplements / Q000191:economics; D004281:Docosahexaenoic Acids / Q000191:economics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005395:Fish Oils / Q000191:economics / Q000627:therapeutic use*; D017721:Hospital Costs; D006779:Hospitals, Public; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D039382:Maternal Nutritional Physiological Phenomena; D017059:Models, Econometric; D010349:Patient Compliance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D057216:Propensity Score; D012044:Regression Analysis; D012907:Smoking / Q000009:adverse effects / Q000191:economics; D013021:South Australia
chemical_list: D005395:Fish Oils; D004281:Docosahexaenoic Acids
keywords: Australia; DHA-rich fish oil supplementation.; Health economics evaluation; Hospital cost analysis; Pregnancy and birth outcomes; Randomized trial