Cora Peterson1, Scott D Grosse2, Rui Li3, Andrea J Sharma4, Hilda Razzaghi5, William H Herman6, Suzanne M Gilboa2. 1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Electronic address: cora.peterson@cdc.hhs.gov. 2. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA. 3. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. 4. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA; US Public Health Service Commissioned Corps, Atlanta, GA. 5. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN. 6. Departments of Internal Medicine and Epidemiology, University of Michigan Medical School, Ann Arbor, MI.
Abstract
OBJECTIVE: Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. We aimed to estimate the preconception care (PCC)-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus (PGDM) in the United States. STUDY DESIGN: Among women of reproductive age (15-44 years), we estimated age- and race/ethnicity-specific prevalence of diagnosed and undiagnosed diabetes. We applied age and race/ethnicity-specific pregnancy rates, estimates of the risk reduction from PCC for 3 adverse birth outcomes (preterm birth, major birth defects, and perinatal mortality), and lifetime medical and lost productivity costs for children with those outcomes. Using a probabilistic model, we estimated the reduction in adverse birth outcomes and costs associated with universal PCC compared with no PCC among women with PGDM. We did not assess maternal outcomes and associated costs. RESULTS: We estimated 2.2% of US births are to women with PGDM. Among women with diagnosed diabetes, universal PCC might avert 8397 (90% prediction interval [PI], 5252-11,449) preterm deliveries, 3725 (90% PI, 3259-4126) birth defects, and 1872 (90% PI, 1239-2415) perinatal deaths annually. Associated discounted lifetime costs averted for the affected cohort of children could be as high as $4.3 billion (90% PI, 3.4-5.1 billion) (2012 US dollars). PCC among women with undiagnosed diabetes could yield an additional $1.2 billion (90% PI, 951 million-1.4 billion) in averted cost. CONCLUSION: Results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care. Published by Elsevier Inc.
OBJECTIVE: Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. We aimed to estimate the preconception care (PCC)-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus (PGDM) in the United States. STUDY DESIGN: Among women of reproductive age (15-44 years), we estimated age- and race/ethnicity-specific prevalence of diagnosed and undiagnosed diabetes. We applied age and race/ethnicity-specific pregnancy rates, estimates of the risk reduction from PCC for 3 adverse birth outcomes (preterm birth, major birth defects, and perinatal mortality), and lifetime medical and lost productivity costs for children with those outcomes. Using a probabilistic model, we estimated the reduction in adverse birth outcomes and costs associated with universal PCC compared with no PCC among women with PGDM. We did not assess maternal outcomes and associated costs. RESULTS: We estimated 2.2% of US births are to women with PGDM. Among women with diagnosed diabetes, universal PCC might avert 8397 (90% prediction interval [PI], 5252-11,449) preterm deliveries, 3725 (90% PI, 3259-4126) birth defects, and 1872 (90% PI, 1239-2415) perinatal deaths annually. Associated discounted lifetime costs averted for the affected cohort of children could be as high as $4.3 billion (90% PI, 3.4-5.1 billion) (2012 US dollars). PCC among women with undiagnosed diabetes could yield an additional $1.2 billion (90% PI, 951 million-1.4 billion) in averted cost. CONCLUSION: Results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care. Published by Elsevier Inc.
Authors: Mary C M Macintosh; Kate M Fleming; Jaron A Bailey; Pat Doyle; Jo Modder; Dominique Acolet; Shona Golightly; Alison Miller Journal: BMJ Date: 2006-06-16
Authors: Catherine Kim; Assiamira Ferrara; Laura N McEwen; David G Marrero; Robert B Gerzoff; William H Herman Journal: Am J Obstet Gynecol Date: 2005-01 Impact factor: 8.661
Authors: Adolfo Correa; Suzanne M Gilboa; Lilah M Besser; Lorenzo D Botto; Cynthia A Moore; Charlotte A Hobbs; Mario A Cleves; Tiffany J Riehle-Colarusso; D Kim Waller; E Albert Reece Journal: Am J Obstet Gynecol Date: 2008-07-31 Impact factor: 8.661
Authors: Sarah C Tinker; Suzanne M Gilboa; Cynthia A Moore; D Kim Waller; Regina M Simeone; Shin Y Kim; Denise J Jamieson; Lorenzo D Botto; Jennita Reefhuis Journal: Am J Obstet Gynecol Date: 2019-08-24 Impact factor: 8.661
Authors: Laura E Britton; Jon M Hussey; Diane C Berry; Jamie L Crandell; Jada L Brooks; Amy G Bryant Journal: J Midwifery Womens Health Date: 2018-12-12 Impact factor: 2.388
Authors: Yanqing Wu; E Albert Reece; Jianxiang Zhong; Daoyin Dong; Wei-Bin Shen; Christopher R Harman; Peixin Yang Journal: Am J Obstet Gynecol Date: 2016-03-31 Impact factor: 8.661