Healthcare costs of pregnancy in XXXX : retrospective observational analysis from a US health claims database.

@entity1 @entity1252 @entity792
OBJECTIVE: @entity1252 is a complex @entity792 , most frequently affecting @entity1 of childbearing age. @entity1 with @entity1252 are at increased risk of pregnancy complications that are exacerbated by active disease. Despite this, their use of medications and hospital resources has not been extensively studied. METHODS: Retrospective analyses of the Truven Health MarketScan database (2006-2012) aimed to quantify drug and resource utilization in pregnant @entity1 with @entity1252 , as well as the incidence of pregnancy complications in these @entity1 . Records of @entity1 aged 12-54 were reviewed and both @entity1252 @entity1 and pregnancies identified. Pregnant @entity1 with @entity1252 were matched 1:5 with either pregnant @entity1 without @entity1252 , or non-pregnant @entity1 with @entity1252 . RESULTS: Pregnancies with @entity1252 were associated with increased complications when compared to pregnancies without @entity1252 . During pregnancy, the use of immunosuppressants decreased in pregnant @entity1 with @entity1252 , as did rheumatologist visits, while the number of @entity1 not treated with any immunosuppressant increased. Pregnant @entity1 with @entity1252 showed higher overall treatment costs than controls. However, compared to non-pregnant @entity1 with @entity1252 , medication costs actually dropped, possibly due to the withdrawal of medications from these @entity1 or @entity1 becoming pregnant while disease activity was low. CONCLUSIONS: The large database analyses reported here revealed that pregnancies in @entity1 with @entity1252 were associated with a higher risk of complications, higher healthcare costs, and fewer prescribed medications, including immunosuppressants, than the control groups. The increased risk of complications and decreased immunosuppressant use suggest that @entity1 require additional guidance from physicians to give them the best chance of experiencing a safe pregnancy. Indeed, despite the recognized role active @entity1252 plays in increasing pregnancy complications, @entity1 with @entity1252 had fewer rheumatology visits during pregnancy, although their visits to their general practitioner/primary healthcare provider increased, highlighting the need for team-based co-ordination care between OBGYN physicians and rheumatologists.
