(924) Differences in maternal and infant hospitalization costs associated with planned postpartum hysterectomy by gestational age

Friday, February 10, 2023

3:30 PM – 5:00 PM

Objective: To describe hospitalization costs associated with planned postpartum hysterectomies for mother and neonate across gestational ages.

Study Design: This was a retrospective cohort study of postpartum persons who delivered in California between 2007-2011. We included singleton, non-anomalous live births between 23-42 weeks’ gestation and had a diagnosis consistent with planned postpartum hysterectomy. Maternal and infant hospitalization costs, adjusted for 2022 US dollars, and length of stay were analyzed separately and were stratified further by gestation. Gestational ages were categorized into less than 34 weeks, between 34-37 weeks, and over 37 weeks. Chi-squared tests were performed and Kruskall-Wallis equality-of-populations rank tests were utilized with a significance level of 0.05.

Results: A total of 1,032 postpartum persons underwent a planned postpartum hysterectomy in this cohort. Of those included, 126 (12%) had a gestational age less than 34 weeks, 427 (41%) had a gestational age of 34-37 weeks, and 479 (46%) had a gestational age of more than 37 weeks. Neonates delivered with a gestational age of less than 34 weeks had both the highest median maternal ($78,882) and infant ($112,639) hospitalization costs. Infants with a gestational age of more than 37 weeks had the lowest median maternal ($45,047) and infant ($64,598) hospitalization costs. Similarly, median infant costs were lowest among infants of more than 37 weeks in the no hysterectomy group ($2,800).

Conclusion: In this study, we found that as gestational ages increased, both maternal and infant hospitalization costs decreased for planned postpartum hysterectomy. Similar results were found for infants of postpartum persons who did not have a hysterectomy. This necessitates further research into factors related to postpartum care and neonatal outcomes by gestational ages in order to decrease economic burden, particularly with earlier gestational ages.

Primary & Presenting Author(s)

Afsoon Ghafari-Saravi
Medical Student
Oregon Health and Science University
Portland, Oregon, United States

Coauthor(s)

Alyssa R. Hersh, MD MPH (she/her/hers)
Resident Physician
Oregon Health and Science University
Portland, Oregon, United States
Bharti Garg, MBBS, MPH
Biostatistician/Data analyst
Department of Obstetrics and Gynecology, Oregon Health and Science University
Portland, Oregon, United States
Claire H. Packer, MD, MPH (she/her/hers)
Resident
Brigham and Women's Hospital, Harvard Medical School
Boston, Massachusetts, United States
Aaron B. Caughey, MD,MPH,PhD
Professor and Chair
Oregon Health and Science University
Portland, Oregon, United States