Societal cost of nine selected maternal morbidities in the United States

Abstract

Objective: To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the United States.

Methods: Using data from 2010 to 2020, we developed a cost analysis model that calculated the excess cases of outcomes attributed to nine maternal morbidity conditions with evidence of outcomes in the literature. We then modeled the associated medical and nonmedical costs of each outcome incurred by birthing people and their children in 2019, projected through five years postpartum.

Results: We estimated that the total cost of nine maternal morbidity conditions for all pregnancies and births in 2019 was $32.3 billion from conception to five years postpartum, amounting to $8,624 in societal costs per birthing person.

Conclusion: We found only nine maternal morbidity conditions with sufficient supporting evidence of linkages to outcomes and costs. The lack of comprehensive data for other conditions suggests that maternal morbidity exacts a higher toll on society than we found.

Policy implications: Although this study likely provides lower bound cost estimates, it establishes the substantial adverse societal impact of maternal morbidity and suggests further opportunities to invest in maternal health.

Fig 1. Conceptual framework of our model that calculates the costs of outcomes attributed to nine maternal morbidity conditions, 2019 birth cohort.

Our model estimated the excess medical and nonmedical costs of maternal and child outcomes associated with maternal morbidity conditions.

Fig 2. Title: Preferred reporting items for systematic reviews and meta-analyses flowchart of article selection for final model, using data primarily from 2010 to 2020.

This figure details the number of articles we found in each of our three searches, the number we selected for full-text review after screening title and abstracts, the number of articles we excluded from the model for each reason, and the final number of articles identified for model inclusion.

Fig 3. Connections between nine maternal morbidity conditions and 24 outcomes, 2019 birth cohort.

This figure illustrates the connections included in our final model between nine maternal morbidity conditions and 24 outcomes. Each connection has a statistically significant evidence base or expert recommendation for inclusions and documented associated costs.