(109) Maternal and neonatal hospitalization costs for births complicated by placenta previa

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Placenta previa is associated with prolonged hospitalization, delivery via cesarean, and increased maternal and neonatal morbidity. We sought to describe the economic impact of placenta previa and its adverse outcomes.

Study Design: This was a retrospective cohort study of pregnant persons with placenta previa between the years of 2007-2011. Inclusion criteria were singleton, non-anomalous births between 23-37 weeks’ gestation. We assessed the hospitalization costs (adjusted to 2022 U.S. dollars) for delivery and length of stay (days) among pregnant persons and neonates separately. In addition, we assessed deliveries complicated by specific maternal and neonatal adverse outcomes. Statistical analyses were performed using chi squared and Kruskal-Wallis equality-of-populations rank tests with a significance level of 0.05.

Results: There were 6,411 births complicated by placenta previa in this cohort. Median costs were higher for pregnant persons and neonates with placenta previa compared to those without (maternal: $25,822 vs. $14,497; neonatal: $6,643 vs. $3,472). Blood transfusion (13.2%) and hysterectomy (7.3%) were associated with higher median maternal and neonatal hospitalization costs. Neonatal intensive care unit (NICU) admission occurred in 40.2% of births and respiratory distress in 36.4% of births, with median neonatal costs surpassing eight times the cost of births without these complications.

Conclusion: Births complicated by placenta previa accrue higher costs when concurrent with other adverse outcomes.

Primary & Presenting Author(s)

Alyssa R. Hersh, MD MPH (she/her/hers)
Resident Physician
Oregon Health and Science University
Portland, Oregon, United States

Coauthor(s)

Afsoon Ghafari-Saravi
Medical Student
Oregon Health and Science University
Portland, Oregon, United States
Osinakachuwku Mbata, BS, MD
Resident
Oregon Health & 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
Aaron B. Caughey, MD,MPH,PhD
Professor and Chair
Oregon Health and Science University
Portland, Oregon, United States