Research calls on screening and interventions to bring down costs and protect mother and baby
A new study from NUI Galway, funded by the Health Research Board, has shown maternity care costs for pregnant women with gestational diabetes are 34% higher than average. Gestational Diabetes Mellitus (GDM) is a form of diabetes which is first diagnosed during pregnancy. It develops in about 12% of pregnancies and is more common in women who are overweight or obese. Previous research has shown that it carries with it increased risks for both mother and baby, but this is the first time the economic implications have been studied in Ireland.
This study explored the determinants of maternity care and costs for a cohort of 4,432 pregnant women in Ireland. In particular, it estimated the independent effects of GDM, over and above the effects of other potentially important determinants, on mode of delivery, neonatal unit admission, and maternity care costs.
From the sample of 4,372 women, those with a diagnosis of GDM were almost twice as likely to undergo an emergency caesarean section, and their infants were three times more likely to be admitted to a neonatal unit. The resulting maternity care costs, specifically calculated by sampling patients from the public healthcare system, were increased by 34%.Of the other variables included in the analysis, maternal obesity was found to increase costs by 21%.
“Aside from the serious health implications, GDM is also placing a substantial economic burden on maternity care costs. This burden is likely to rise in the future if current practices remain unchanged given projected increases in GDM prevalence rates. However, what our study really highlights are the potential cost savings which may go to offset the costs of interventions that aim to prevent the onset of GDM in pregnancy,” explains Dr Paddy Gillespie, from the School of Business and Economics at NUI Galway.
Professor Fidelma Dunne, Consultant Endocrinologist and Head of School of Medicine at NUI Galway, headed-up the Atlantic DIP research and co-authored this week’s study. Professor Dunne pointed out that the cost of interventions, such as universal screening, could potentially be offset by the reduced number of women requiring more costly medical care.
“GDM is a significant public health concern for women and their babies in Ireland. It can lead to future diabetes in the mother and diabetes and obesity in their children, with indications that it is contributing to the global diabetes epidemic. Ireland needs to introduce universal screening of women in pregnancy for GDM, rather than the current approach of selective screening. We also need to look at lifestyle interventions and educating women about vitamin supplements, diet and exercise through their ante-natal centres and GPs.”
The research, ‘Modelling the Independent Effects of Gestational Diabetes Mellitus on Maternity Care and Costs’, was funded by the Health Research Board, was published this week in the international peer-reviewed journal Diabetes Care. Data for the study came from the five-year project Atlantic Diabetes in Pregnancy (Atlantic DIP), which measured the incidence and outcomes of diabetes in pregnancy in the west and north-west of Ireland.