Estimating the cost of pre-eclampsiain the health system: a cross-sectional analysis using data from the Screening for Pregnancy Endpoints (SCOPE) study.

3 Sep 2015

Pre-Eclampsiais a pregnancy specific condition characterised by a significant rise in blood pressure (>140/90mmHg) and new onset proteinin the urine (>300mg in 24 hours) after 20 weeks gestation (1).
It accounts for 12% of maternal deaths per year globally (1), affecting 2-3% of all Irish pregnancies (2). Forthe mother it can lead to the development of long term morbidities, and increases the risk of future hospitalisation. Furthermore it can impact infant development by increasing the risk of preterm birth and low birth-weight (3).
As the only treatment for pre-eclampsiais delivery requiring increased monitoring during pregnancy, pre-eclampsiahas been associated with increased health service use.One of the only studies which examined such impact of pre-eclampsiaon health care costs was carried out in Ontario, Canada 2009. Pre-eclampsiaaccounted for an additional cost of CAD$3.1 million annually, associated with increased cesarean sections performed ,and long term care for low birthweight infants born to women with pre-eclampsia (4). To date there is no such study in Ireland, either accounting for thecost of pre-eclampsia,or a detailed account of health service use in this high risk group.
The purpose of this study was to examine the health service use of women with pre-eclampsiaand those without pre-eclampsiain Ireland.

Cross-sectional analysis of data from women in Ireland who participated in the Screening for Pregnancy Endpoints study (SCOPE).The SCOPE study is a prospective international multi-centred study of ‘healthy’ nulliparous women which aims to provide a database of information on all clinical risk factors for preterm birth related to pre-eclampsia, small for gestational age (SGA) infants and spontaneous pre-term birth (SPTB) (2).
SCOPE participants were healthy nulliparous women with singleton pregnancies recruited between March 2008 and February 2011 in Cork Ireland (n=1774). All women who agreed to take part were seen at 14-16 weeks and 19-21 weeks gestation when they completed an extensive questionnaire and underwent detailed physical assessment by trained research midwives.
Women with preeclampsia (n=68)and a 10% random sample of women without pre-eclampsia(n=171) selected from SCOPE Ireland dataset.
Data Collection
Retrospective data on health service use were extracted from participants’ medical records (carried out between August 2014and June 2015). This information was then merged with the existing SCOPE dataset which contained socio-demographic and clinical information on participants.
Data Management and Analysis
Data gathered included both sociodemographics of the participants and health service use.
Heath service use data was divided into three terms: antenatal, perinatal, and 12 months postnatal

Citation for this resource: 
Fahy C, McHugh S, Kearney P, et al. PP19 Estimating the cost of pre-eclampsia in the health system: a cross sectional analysis using screening for pregnancy endpoints (scope) study. Journal of Epidemiology and Community Health. 2015;Vol(Suppl 1):A60-A1.
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