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

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  • Patrick S Moran
  • Francesca Wuytack
  • Michael Turner
  • Charles Normand
  • Stephanie Brown
  • Cecily Begley
  • Deirdre Daly

Abstract

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.

Suggested Citation

  • Patrick S Moran & Francesca Wuytack & Michael Turner & Charles Normand & Stephanie Brown & Cecily Begley & Deirdre Daly, 2020. "Economic burden of maternal morbidity – A systematic review of cost-of-illness studies," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-18, January.
  • Handle: RePEc:plo:pone00:0227377
    DOI: 10.1371/journal.pone.0227377
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    References listed on IDEAS

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    2. Bauer, Annette & Pawlby, S. & Plant, D. T. & King, Derek & Pariante, C. M. & Knapp, M., 2015. "Perinatal depression and child development: exploring the economic consequences from a South London cohort," LSE Research Online Documents on Economics 57718, London School of Economics and Political Science, LSE Library.
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    2. Kass, Benjamin & Roll, Stephanie & Bolster, Marie & Heinrich-Rohr, Michaela & Kuchinke, Lars & Ludwig-Körner, Christiane & Schlensog-Schuster, Franziska & Fricke, Julia & Berghöfer, Anne & Keil, Thoma, 2024. "Utilization and costs of health care and early support services in Germany and the influence of mental health burden during the postnatal period," Children and Youth Services Review, Elsevier, vol. 157(C).
    3. Cintia Chamorro-Petronacci & Carmen Martin Carreras-Presas & Adriana Sanz-Marchena & María A Rodríguez-Fernández & José María Suárez-Quintanilla & Berta Rivas-Mundiña & Juan Suárez-Quintanilla & Mario, 2020. "Assessment of the Economic and Health-Care Impact of COVID-19 (SARS-CoV-2) on Public and Private Dental Surgeries in Spain: A Pilot Study," IJERPH, MDPI, vol. 17(14), pages 1-9, July.
    4. Carmen Pheiffer & Stephanie Dias & Sumaiya Adam, 2020. "Intimate Partner Violence: A Risk Factor for Gestational Diabetes," IJERPH, MDPI, vol. 17(21), pages 1-17, October.

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