Maternal pre-pregnancy obesity and health care utilization and costs in the offspring

Abstract

Background/objective The association between maternal pre-pregnancy obesity and adverse child health outcomes is well described, but there are few data on the relationship with offspring health service use. We examined the influence of maternal pre-pregnancy obesity on offspring health care utilization and costs over the first 18 years of life. Methods This was a population-based retrospective cohort study of children (n = 35,090) born between 1989 and 1993 and their mothers, who were identified using the Nova Scotia Atlee Perinatal Database and linked to provincial administrative health data from birth through 2014. The primary outcome was health care utilization as determined by the number and cost of physician visits, hospital admissions and days, and high utilizer status (>95th percentile of physician visits). The secondary outcome was health care utilization by ICD chapter. Maternal pre-pregnancy weight was categorized as normal weight, overweight, or obese. Multivariable-adjusted regression models were used to examine the association between maternal weight status and offspring health care use. Results Children of mothers with pre-pregnancy obesity had more physician visits (10%), hospital admissions (16%), and hospital days (10%) than children from mothers of normal weight over the first 18 years of life. Offspring of mothers with obesity had C$356 higher physician costs and C$1415 hospital costs over 18 years than offspring of normal weight mothers. Children of mothers with obesity were 1.74 times more likely to be a high utilizer of health care and had higher rates of physician visits and hospital stays for nervous system and sense organ disorders, respiratory disorders, and gastrointestinal disorders compared to children of normal weight mothers. Conclusion Our findings suggest that maternal pre-pregnancy overweight and obesity are associated with slightly higher offspring health care utilization and costs in the first 18 years of life.

Association of Body Mass Index With the Use of Health Care Resources in Low-Risk Nulliparous Pregnancies After 39 Weeks of Gestation

“…To our knowledge, none were specifically in low-risk people. 5,[13][14][15][16][17] For example, analysis of electronic data records of 13,422 pregnant people from a U.S. group-practice health maintenance organization from 2000 to 2004 showed that a higher-than-normal BMI was associated with a prolonged length of hospital stay for delivery (4.060.1 days and 4.460.1 days for those with BMIs in the obese and extremely obese ranges compared with 3.660.1 days for those with BMIs in the normal range), with the bulk of increase related to higher rates of cesarean delivery. 5 However, the difference remained significant after correction for mode of delivery.…”

“…14,[16][17][18][19][20] A cross-sectional analysis of 16,262 patients from the 2000 Medical Expenditure Panel Survey in the United States demonstrated that excess costs among adults with morbid obesity resulted from greater expenditures for office-based visits, outpatient and in-patient hospital care, and prescription drugs. Moreover, overweight and obese BMI status in pregnant people were associated with increased costs of care for the newborn and child, compared with those BMIs in the normal range, 14,18 and modeling estimates of the average incremental costs associated with pregnancy and birth were more than $18,290. 19 We demonstrate a robust association between maternal BMI and increased utilization of health care resources in low-risk pregnancies.…”

Non-invasive prenatal testing in mitigating concerns from invasive prenatal diagnostic testing: retrospective assessment of utility in an academic healthcare system in the US

“…We looked at the longitudinal variation to see if the numbers of NIPT and IPD over time align with or exceeds the changes in the number of new high-risk pregnancies with advanced maternal age. Analytic cohort included pregnant women with one or more records of high-risk pregnancy (ICD-10-CM O09.x or ICD-9-CM V23.x) between January 2012 and December 2018 24–30. Eligible subjects were 35 years old or older at the first date of the high-risk pregnancy diagnosis.…”

Impact of Maternal Obesity on Liver Disease in the Offspring: A Comprehensive Transcriptomic Analysis and Confirmation of Results in a Murine Model

“…Besides increased perinatal complications, maternal obesity also leads to increased morbidity in the children of obese mothers [ 6 , 7 , 8 ]. In particular, maternal obesity is a risk factor for compromised cognitive development, metabolic syndrome, and even childhood cancers [ 9 , 10 , 11 ].…”