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The effect of severe maternal morbidity on infant costs and lengths of stay

Journal of Perinatology volume 42, pages 611–616 (2022)Cite this article

Subjects

Abstract

Objective

To examine the association between severe maternal morbidity (SMM) and infant health using the additional infant costs and length of stay (LOS) as markers of added clinical complexity.

Study design

Secondary data analysis using California linked birth certificate-patient discharge data for 2009–2011 (N = 1,260,457). Regression models were used to estimate the association between SMM and infant costs and LOS.

Results

The 16,687 SMM-exposed infants experienced a $6550 (33%) increase in costs and a 0.7 (18%) day increase in LOS. Preterm infants had ($11,258 (18%) added costs and 1.3 days (8.1%) longer LOS) than term infants ($2539 (38%) added costs and 0.5 days (22%) longer LOS).

Conclusions

SMM was associated with increased infant costs and LOS, suggesting that SMM may have adverse health effects for infants, including term infants. The relatively larger effect on costs indicates an increase in treatment intensity (clinical severity) greater than additional LOS.

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Fig. 1: Marginal increase in infant costs and length of stay associated with severe maternal morbidity.
Fig. 2: Marginal increase in infant costs and length of stay associated with severe maternal morbidity, by transfusion only SMM (txSMM) vs. non-transfusion SMM (ntSMM).

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Funding

Partial support provided by NIH/NICHD R01s HD084819 and HD099197.

Author information

Authors and Affiliations

  1. Loyola Marymount University, Los Angeles, CA, USA

    Claire M. Phibbs

  2. Division of Health Policy and Management, University of Minnesota School of Public Health, Minnesota, MN, USA

    Katy B. Kozhimannil

  3. Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA

    Stephanie A. Leonard & Elliott K. Main

  4. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Scott A. Lorch

  5. Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Pennsylvania, PA, USA

    Scott A. Lorch

  6. California Maternal Quality Care Collaborative, Los Angeles, CA, USA

    Elliott K. Main

  7. Health Economics Resource Center, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA

    Susan K. Schmitt & Ciaran S. Phibbs

  8. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Susan K. Schmitt & Ciaran S. Phibbs

Authors
  1. Claire M. Phibbs
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  2. Katy B. Kozhimannil
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  3. Stephanie A. Leonard
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  4. Scott A. Lorch
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  5. Elliott K. Main
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  6. Susan K. Schmitt
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  7. Ciaran S. Phibbs
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Contributions

CSP jointly (with CMP) conceived the initial idea of a project examining the costs associated with Severe Maternal Morbidity (SMM), collaborated with all of the other authors to design the study, supervised the analyses of the data, and jointly drafted the initial manuscript (with CMP), and reviewed and revised the manuscript. CMP jointly conceived the initial idea for the project, collaborated with all of the other authors to design the study, jointly drafted the initial manuscript, and reviewed and revised the manuscript. KBK, SAL, SAL, and Main all participated in the design of the study and reviewed and revised the manuscript. SKS participated in the design of the study, carried out all of the data analyses, and reviewed and revised the manuscript. CSP was PI for both the grants that provided partial support to this manuscript (HD084819 and HD099197); SAL was co-PI for HD084819.

Corresponding author

Correspondence to Ciaran S. Phibbs.

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The authors declare no competing interests.

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Phibbs, C.M., Kozhimannil, K.B., Leonard, S.A. et al. The effect of severe maternal morbidity on infant costs and lengths of stay. J Perinatol 42, 611–616 (2022). https://doi.org/10.1038/s41372-022-01343-3

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