Economic burden of maternal morbidity – A systematic review of cost-of-illness studies


Autoři: Patrick S. Moran aff001;  Francesca Wuytack aff001;  Michael Turner aff002;  Charles Normand aff003;  Stephanie Brown aff005;  Cecily Begley aff001;  Deirdre Daly aff001
Působiště autorů: School of Nursing and Midwifery, Trinity College, Dublin, Ireland aff001;  School Of Medicine, University College, Dublin, Ireland aff002;  Centre for Health Policy and Management, Trinity College, Dublin, Ireland aff003;  Cicely Saunders Institute, King’s College, London, United Kingdom aff004;  General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia aff005;  Murdoch Children’s Research Institute, Melbourne, Australia aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227377

Souhrn

Aim

To estimate the economic burden of common health problems associated with pregnancy and childbirth, such as incontinence, mental health problems, or gestational diabetes, excluding acute complications of labour or birth, or severe acute adverse maternal outcomes.

Methods

Searches for relevant studies were carried out to November 2019 in Medline, Embase, CINAHL, PsycINFO and EconLit databases. After initial screening, all results were reviewed for inclusion by two authors. An adapted version of a previously developed checklist for cost-of-illness studies was used for quality appraisal. All costs were converted to 2018 Euro using national consumer price indices and purchasing power parity conversion factors.

Results

Thirty-eight relevant studies were identified, some of which reported incremental costs for more than one health problem (16 gestational diabetes, 13 overweight/obesity, 8 mental health, 4 hypertensive disorders, 2 nausea and vomiting, 2 epilepsy, 1 intimate partner violence). A high level of heterogeneity was observed in both the methods used, and the incremental cost estimates obtained for each morbidity. Average incremental costs tended to be higher in studies that modelled a hypothetical cohort of women using data from a range of sources (compared to analyses of primary data), and in studies set in the United States. No studies that examined the economic burden of some common pregnancy-related morbidities, such as incontinence, pelvic girdle pain, or sexual health problems, were identified.

Conclusion

Our findings indicate that maternal morbidity is associated with significant costs to health systems and society, but large gaps remain in the evidence base for the economic burden of some common health problems associated with pregnancy and childbirth. More research is needed to examine the economic burden of a range of common maternal health problems, and future research should adopt consistent methodological approaches to ensure comparability of results.

Klíčová slova:

Birth – Diabetes mellitus – Economics – Health economics – Hypertensive disorders in pregnancy – Morbidity – Obesity – Pregnancy


Zdroje

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